Insurance
Dr. Natbony and IHMNY do not participate with any insurance plans. Payment is due in full at the time of service. Pricing for visits and procedures can be found under Services. After each visit, we will provide you with a receipt as well as a “superbill” with the correct CPT and diagnosis codes. These can be submitted by you to your insurance company for potential reimbusement, depending on your out-of-network benefits.
We cannot guarantee that you will be reimbursed, as each insurance plan is unique. We encourage you to contact your plan to understand your coverage and reimbursement.
Policies
Cancellation Policy
There is no charge for appointments canceled 24 or more hours before the start of your scheduled appointment. If canceled within 24 hours, the full amount of the visit will be charged.
Late Policy
Patients arriving late will only be seen during their regularly scheduled appointment time and may have their appointment times cut short. If you arrive too late, you may be asked to reschedule. Late patients are charged the full fee for their scheduled service.
No Show Policy
Patients who do not attend their scheduled appointment will be charged the full amount of the visit unless they cancel 24 hours or more in advance.
Prescription Refill Policy
Many times, refills are on file with your pharmacy. You can find the number of refills you may have on your prescription bottle. In this case, simply contact your pharmacy with your request and have your prescription number ready – that information can be found on your prescription bottle.
Generally, you should have enough refills to hold you until your next appointment with us – if you notice that you are running low on your medication, it likely means that you need to schedule an appointment. All patients are required to have an appointment with us – either in person or by telemedicine – at a minimum of every 6 months. After 1 year of not being seen, patients are considered inactive and prescriptions will not be refilled.
If your pharmacy will not initiate a refill request, please contact us through our secure patient portal to request your refill. Please specify the name of the medication, the dosage and the name and contact information of your pharmacy. Generic medication will be E-prescribed to your pharmacy unless you have specified to order name brand(s) only in your request.
Our office requires 5 business days to respond to any prescription request and these are processed in the order they are received. Please plan ahead for the refills you will need – do not wait until the last minute as this may mean that you risk running out of your medication before it can be refilled.
Prior Authorization Policies
Prior Authorization Requests (PAs) are generated by the pharmacy when a non-covered prescription is received from our office. There is no need for you to call us to initiate a PA. PAs will be initiated by our office within 5 business days of the request and the status of the PA should be determined within the following 3-5 business days. The status of the PA will automatically be sent to your pharmacy. It is advisable for you to call your pharmacy directly approximately 10 days after a PA has been requested and ask your pharmacist to “rerun” the prescription.
Obtaining prior authorizations can take hours of time. To support our administrative staff, we charge a PA fee of $100 per medication per year.
If your PA is denied:
- You may still get your prescription filled through a savings/access program for the specific brand name medication. Examples include, but are not limited to, Nurtec, Qulipta, Ubrelvy.
- Some Savings Programs may require a PA to be initiated after the 1st or 2nd prescription fill, but the PA does not need to be approved.
- If a PA is denied, it may be worth appealing the decision, knowing there are no guarantees. If you want us to appeal your denial, our fee for this assistance ranges from $50 to $100 depending on the complexity of the appeal. To initiate this process you must provide us with a brief letter addressed to your insurance carrier, explaining why you want the particular medication and/or procedure. We will include your letter with the information we submit on your behalf for the appeal.
Communication Policy
In the case of emergencies or life-threatening symptoms, please call 9-1-1 or visit your nearest Emergency Department.
For simple questions (ex., appointments, office hours, yes/no answers), we encourage you to use our patient portal. You can also text or call us. For all messages, please allow up to 48 business hours for a response to your question. A follow-up visit is required for all other in-depth questions (ex., medication management, side effects, test results, new symptoms, etc.).
Forms and Paperwork Policy
Filling out forms is best done as part of an office visit. There will be a minimum $75 charge if done outside of an office visit. This fee also applies to requests for letters to be written.
Credit Card on File Policy
We require a credit card on file to reserve your dedicated appointment slot.
Resources
Documents
Documents
Dr. Natbony’s Headache Guides (Coming Soon)
Botox Resources
Botox Resources
Headache Organizations
Headache Organizations
Advocacy & Support
Advocacy & Support
Frequently
Asked Questions
Please review the frequently asked questions below. If you don’t find the answer to your question, feel free to contact us.
Do you take insurance?
Integrative Headache Medicine of New York does not participate with insurance plans. An itemized statement and receipt of payment will be provided at the time of the encounter that you may submit to your insurance plan for reimbursement, depending on your out-of-network benefits.
Why don’t you take my insurance?
Today there are hundreds of healthcare insurance companies, each with dozens of plans. Each plan has its restrictions and its own rules, and payment policies for physicians, both of which are constantly changing. In addition, employer and individual plans may vary depending upon the benefits package purchased, so there is even variation between insured members that may even be on the same plan. Trends in insurance reimbursement are dramatically reducing the payment for all types of medical care. Doctors who participate in insurance plans are forced to accept far less than traditional fees and the level of reimbursement is continuing to decrease, while the costs of maintaining a practice are increasing. As a result, the level of care may be compromised.
Integrative Headache Medicine of New York practices an integrated approach to headache medicine, and commercial insurance plans do not recognize or pay for all that is involved in providing comprehensive traditional and complementary medicine. Quality care takes time and expertise. As such, we are unable to provide the level of care that we do if we participate with insurance plans.
What if I have out-of-network benefits?
If you have out-of-network benefits, you can submit our charges to your plan for adjudication and reimbursement for your out-of-pocket expense. Factors like deductibles and cost-sharing may apply. For information on your specific benefits – such as what is covered, what is not, and why – please refer to the benefits guide provided by your employer or your plan at the time of enrollment or call the member number located on your insurance card.
Many plans require that you meet a deductible amount (whether in-network or out-of-network). This means that a certain amount of the claim payment will be withheld in order to meet the deductible amount within a given time period. For example, you may have a $2,000 deductible, in which case your insurer will only start paying claims once you have reached $2,000 in services paid out of your own pocket.
Some plans also have a coinsurance provision, which means that the member/patient shares in a portion of the total payment for services rendered – in addition to a deductible – by paying a percentage of the total allowable (fee) due to the practice. Your insurer will process your claim, determine if there is a cost-share amount, and reimburse you for any amount due to you from there.
For the most part, you can expect that whether you have in-network benefits or out-of-network benefits, you will need to satisfy your deductible before any benefits or reimbursement from your insurance company is extended. Patients with out-of-network benefits can expect to be reimbursed for some or most of your out of pocket expenses once their deductible is met.
Do you accept Medicare?
We are not currently accepting new Medicare patients at this practice. We are happy to provide referrals to providers who are in-network or opted out of Medicare.
I need an MRI and blood tests. Are those covered?
Yes. All outside testing gets billed through your insurance. For labs, we typically utilize either Labcorp or Quest, but it is your responsibility to check which one is the preferred lab provider for your insurance. For imaging, we work with several leading radiology offices in New York – please also verify which one accepts your insurance if you desire to stay in-network.
How should I prepare for my first visit?
Make sure to complete all paperwork and intake forms at least 24 hours before your scheduled appointment. Please email, fax, or bring the following documents with you:
- Medical records from other treating physicians
- Any diagnostic testing results (lab results, MRI, CT scans, etc) done within the last year. If you have a disc with images, please bring it to your appointment.
- A list of all medications, including dosages and directions (supplements, herbs, and OTC medications included)
Email: [email protected]
Fax: 646-933-4822I want to do a telemedicine visit. Are there any restrictions?
Medical licensing laws allow physicians to see patients via telemedicine in any state where they hold a medical license. The patient must be physically present in that state at the time of the visit. Dr. Natbony holds medical licenses in New York, New Jersey and Florida. Thus, in order to be seen via telemedicine, you must be in one of these states at the time of your visit.
DELETE??? Forms
New Patient – If you are a new patient, please click the link below to fill out your intake forms online at least 48 hours prior to your visit.