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Patient Information

Insurance and Payment Information
Prescription Assistance | Hospital Affiliations
What to Bring to Your Appointment
Patient Forms
Patient Responsibilities

Insurance and Payment Information

Allergy and Immunology on Madison, P.C., is a provider for most health insurance plans. Please contact us to verify coverage. The carriers we accept include:

• Aetna/USHealthcare
• BlueCross/BlueShield (BCBS)
• Benesight
• Cigna HMO/PPO
• Empire
• GHI
• Great West
• Guardian
• Healthnet
• HIP
• Horizon Healthcare
• Magnacare
• Medicare
• MultiPlan
• Nipon
• Oxford
• PCHS
• PHS
• Pomco
• Prudential
• Unicare
• United Health Care

Prescription Assistance

• NeedyMeds.org
• Partnership for Prescription Assistance
• Free For All, Incorporated (free or discounted medicine, testing, etc.)

Hospital Affiliations

• NYU Hospital - 550 First Avenue, New York, New York 10016
• Beth Israel Medical Center - First Avenue at 16th Street, New York, New York 10003
• Valley Hospital - 223 N. Van Dien Avenue, Ridgewood, New Jersey 07450

What to Bring to Your Appointment

• Information about your medical and surgical history
• List of prescriptions and/or over-the-counter medication, including dose and frequency
• Recent x-rays or relevant records
• Physician referral forms, if required by insurance
• Your insurance card
• Completed Patient Registration Form

Patient Forms

New patients: Please complete our Patient Registration Form prior to your initial visit.

Our Notice of Privacy Practices describes how we use and protect your personal health information.

Patient Responsibility

Patient is responsible for all referrals, co-payments, coinsurance, deductibles and all approved, covered and non-covered charges, whether paid or not paid by the insurance company on the day of service.

24-hour cancellation policy in effect—$75 fee

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