Administrative Information

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Insurance and Payment Information

Cancellation policy


You must give 24 hours notice if you cannot keep your appointment to avoid being charged a $50 cancellation fee.


Insurance plans

Dr. Weiss accepts:

  • Cigna (in-network):
    Actors’ Equity and all other plans except ‘Exchange’ plans.
  • SAG/AFTRA Health Plan (out-of-network):
    We will accept the insurance.  Most charges are covered.  Please call for further information.
  • United Healthcare (in-network):
    All plans except ‘Oxford,’ ‘The Empire Plan,’ ‘Exchange’ plans.
    If your United Healthcare card has ‘Oxford’ under the logo or ‘The Empire Plan’ on the front, then Dr. Weiss is out-of-network.
  • Workers’ Compensation, New York State:
    Professional performers only.
    A copy of the ‘C-2’ form from your employer is required at the time of your first visit.
  • Workers’ Compensation, other states:
    Professional performers only.
    Unfortunately, we have found that insurance companies from some states will not pay a reasonable fee for our services and are, in general, extremely uncooperative.  Therefore, Workers’ Comp cases from states other than NY are only accepted on an individual basis. 
    At this time, we are not accepting any cases insured by The Hartford, as they consistently obstruct us from obtaining proper medical care for our patients.

Dr. Weiss does NOT ;accept:

  • Medicare
  • Medicaid
  • Exchange Plans
  • No-Fault (motor vehicle accident insurance)
  • Any other insurance

If you have these insurances, you can see Dr. Weiss in consultation, but payment is required at the time of service.
For all plans where Dr. Weiss is “out-of-network” and for no-fault, we will give you a claim form that you can submit to your insurance company so that you can obtain reimbursement.

IMPORTANT:  Medicare patients cannot receive any reimbursement from Medicare or any other insurance plan, as Dr. Weiss has ‘opted out’ of Medicare.

Supplies

For braces and splints, please be advised that even if we bill your insurance, the costs of braces and splints are your responsibility.  These charges may be subject to a separate co-payment or a separate deductible, according to the specifics of your insurance policy.

Payment options

For payment we accept:

  • Check
  • Debit Cards
  • Credit Cards (Mastercard, Visa, American Express, Discover)
 

Office Forms

PDF Medical Records Authorization
This form can be used to request that Dr. Weiss (1) send your medical records to another physician or to any other person that you authorize, or (2) request your medical records from another physician or healthcare facility.

PDF Patient Demographics Form
Please complete this demographics form before you visit for your consultation.
Download and save the form. Open on your computer using Adobe Acrobat Reader or on other devices (iPad, iPhone, or Android device) using "Adobe Fill & Sign." Save the completed form on your device and email it to the office before your visit.

PDF Patient Medical History Form
Please complete this medical history form before you visit for your consultation.
Download and save the form. Open on your computer using Adobe Acrobat Reader or on other devices (iPad, iPhone, or Android device) using "Adobe Fill & Sign." Save the completed form on your device and email it to the office before your visit.

PDF Map of NYU Langone Medical Center
Map of the main campus of NYU Langone Medical Center, including Faculty Practice Radiology in the Schwartz Health Care Center.

PDF Neighborhood Map
Map of NYU Langone sites on the east side of Manhattan, including my office (#7 on map).

PDF Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.