We understand that insurance coverage and out-of-pocket costs are major concerns for our patients. We also know that this topic can be a confusing issue. For these reasons, we have dedicated this page to further explaining how our practice handles our coverage and cost policies. If you still have any questions or concerns, please do not hesitate to call our office
- Please note that we exclusively focus our services on the surgical treatment of endometriosis. For that very reason, we only practice in New York City, and Dr. Tamer Seckin and Dr. Karli Goldstein only operate out of Lenox Hill Hospital. The hospital accepts most insurance plans. However, they do not participate with out-of-state Medicare or Medicaid plans. Please be advised that Seckin Endometriosis Center does not participate in the following insurance plans: Medicare, Medicaid, and all Medicaid-sponsored plans.
- Please note that we will work with most major insurance companies if you have out-of-network benefits. No matter your coverage, we encourage you not to let any insurance setbacks come between you and your health and what we can do to treat your endometriosis. When you confirm your registration, please provide the new patient coordinator with your insurance information.
Seckin Endometriosis Center (SEC) is dedicated to surgical treatment. For these reasons, the following information applies strictly to surgeon charges. This does not include billing for the hospital, anesthesia and other providers involved in your care. Also, travel and lodging is not a part of our quote but should be taken into account by patients traveling from out of state.
How do you handle insurance?
Seckin Endometriosis Center is an out-of-network provider with all insurance companies. This means we bill patient insurance carriers at no cost and help with customer support, but our services will process as an out of network practice. Thus, we do accept insurance, but we simply balance and bill the patient. By doing this, patients can receive the treatment that they need to remove the disease while limiting the cost of their surgery.
What does it mean to be an out-of-network provider?
An out-of-network provider is a fairly common practice in such specialized fields as endometriosis deep-excision surgery. Out-of-network means that while we accept most insurances, we are not contracted to any single insurance plan, but rather operate outside of insurance companies’ preferred provider networks.
What if I do not have out-of-network coverage?
Patients without out-of-network coverage, which includes TriCare, are considered self-pay. But keep in mind, if you do not have any insurance coverage or cannot afford to pay for your treatment, there are a number of ways to obtain financing or medical loans to cover the costs.
Why do you choose to remain an out-of-network provider?
While, at first glance, insurance companies seem to lower out-of-pocket costs, this can often come at the expense of provider's decision-making and, in turn, negatively impact the quality of care you receive. To avoid this limitation, we choose to remain an out-of-network provider. As such, we can maintain autonomy and thus improve patient care so that you receive the treatment that you both need and deserve. Additionally, by working with you and your accepted insurance, we are able to limit out-of-pocket costs. The decision you make in your treatment should be between patient and provider, with no third party involvement, especially one that focuses strictly on the financial aspect of your care. While we acknowledge that this is, of course, a key component to your decision-making, we urge you to put your health first. Your health is priceless and our goal is to make sure that patients receive the best treatment based on their individual case, in order to ensure they have the highest chance of symptom relief and a healthy recovery.
What is the advantage of an out-of-network provider versus in-network provider?
The difference between in-network and out-of-network providers differ in whether or not you are seeking care outside of your insurance company’s preferred provider network. While an in-network provider will be covered by insurance, they can be restricted in providing the proper fine-tuned and expert care that we provide here at Seckin Endometriosis Center. By remaining an out-of-network practice, we ensure that our patients receive optimal care catered to their individual case.
What do I need to provide for an insurance check?
The first step we take in limiting the cost of your surgery is checking to see if your insurance provides out-of-network coverage. We perform this evaluation at no fee, but simply request our patients to send their insurance information within their records package. Patients must make a clear copy, front and back, of their insurance card prior to arrival. Along with this, please send your name, date of birth and social security number of both you and the cardholder, making sure to specify who is the patient and who is the cardholder, or if they are one and the same. This information will enable us to determine your coverage, and find the best way to lower your costs. Please feel free to call and discuss your care personally with your insurance company, before sending us any information.
How will you work with my insurance?
After your insurance information is sent and received by our office, our front desk administrative team will work to check your eligibility and benefits. We will discuss what is covered by your insurance and the resulting out-of-pocket costs upon booking your appointment. At this time, we will also provide pre-certification for your surgery if needed. Payment for the cost of your initial expenses will be due at the time of your pre-op. Throughout this process, we aim to lower patient costs and expenses at all times by working individually with patients and their provided insurance networks. Laparoscopic deep-excision surgery is the gold standard of care that endometriosis patient both need and deserve, and we work with our patients to make this a reality.
How much does your treatment cost?
Our fees for treatment vary greatly depending on what you receive: a consultation, an examination with presumptive diagnosis, or most commonly, all of the above along with laparoscopic surgery for complete removal of all endometriosis. Your insurance and whether or not they accept out-of-network providers also plays a key role in determining the final cost of your surgery. Thus, fees for surgery cannot be determined until the doctor actually sees the extent of endometriosis and can assess what is involved with its complete removal.
What are accepted forms of payment?
We accept all forms of payment, including Visa, Mastercard, American Express, Discover and personal checks.
How we aid patients in understanding and lowering the cost of their surgery:
We are happy to help patients gain an understanding of the charges and payments that may become necessary in order to have the best proper care. No one deserves surprises upon receiving a bill for their surgery, especially those suffering from endometriosis. For this reason, we not only aim to answer any questions patients may have, but we also do our best in providing a rough estimation. We work to lower the cost of our patient surgeries on a case-by-case basis by providing any assistance required to both gain maximum benefits from health coverage and ensure your entire experience goes as smoothly as possible. For example, for patients with large deductibles and out-of-pocket costs, we sometimes recommend doing self-pay in order to gain self-pay discounts.
While Seckin Endometriosis Center is not a member of any insurance network, this does not mean that all or part of your surgery will not be covered. Once you have a diagnosis, you should discuss your condition with your insurance carrier to determine how much of your treatment plan will be covered under your policy, especially if you need pre-certification before surgery or have a deductible that needs to be met. Our staff will assist you in dealing with your insurance company and with the paperwork necessary to file a claim. Please speak to our office about your situation and we will kindly put you in touch with an appropriate lender.
Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at 646-960-3040
or have your case reviewed by clicking here.