We take all commercial, Medicare, and Medicaid Plans.

Before your first visit, please print and fill out these forms. For your appointment, be sure to bring with you:

Allowed Amount

Also referred to as approved charge, allowable charge, this is the dollar amount typically considered payment in full by your insurance company along with its network providers. The allowed amount is a discounted rate rather than the actual charge. For example, you visit a doctor who is an in-network provider of your insurance, and the total charge for the visit was $100. Your doctor is required to accept $80 as payment in full for the visit. This is the allowed amount. Your insurance will pay your doctor $80, minus any co-pay or deductible that you may owe. The remaining $20 is considered “write off”, and you cannot be billed for it. If your doctor is not within your insurance network (an out of network provider) you may be responsible for the full charge of $100.

Co-Payment (Copay):

A dollar amount your insurance may require you to pay for an office visit at the time of your appointment. It is required to be paid at every office visit.


The amount that your insurance may require you to pay for covered medical services

After you have satisfied co-payment and/or deductible. It is typically expressed as a percentage (%) of the allowable charge for covered medical services. For example: if the coinsurance is 80/20 your insurance covers 80% of the allowable charge, then you are required to pay the remaining 20% of coinsurance.


A dollar amount that your insurance may require you to pay out of pocket each year

BEFORE your insurance plan begins to make payments for claims. Not all plans require a deductible; therefor always check with your insurance company to see if your plan has any deductibles. Deductibles reset on a renewal date, which is typically January 1st

Out-of-network Providers:

Healthcare providers who are not contracted with the health insurance plan. Typically, if you visit a provider within your insurance’s network (in-network provider), the dollar amount for the medical services will be less than if you go to an out-of-network provider.

Out-of-Pocket Limit (OOP Limit, Stop-Loss or Coinsurance Limit):

The most you have to pay for covered medical services in a plan year. After you spend this amount on a deductible, co-pay, and coinsurance than will your insurance pay 100% of the costs of covered benefits. Just like the deductibles, out-of-pocket maximum resets with the plan every year.

Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of your health records:
Ask us to correct health and claims records:
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you feel your rights are violated

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
In these cases we never share your information unless you give us written permission:

Our Responsibilities

For more information see: HHS Privacy Complaints

Our Uses and Disclosures:

How do we typically use or share your health information? We typically use or share your health information in the following ways.
Help manage the health care treatment you receive:
Run our organization:
Pay for your health services:
Administer your plan:
Respond to organ and tissue donation requests and work with a medical examiner or funeral director:
Address workers’ compensation, law enforcement, and other government requests:
Respond to lawsuits and legal actions:

Changes to the Terms of This Notice

This Notice of Privacy Practices applies to the following organization – North Jersey Foot & Ankle Center

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