1026 Union Road
West Seneca, NY
Phone
Fax
716.712.0851
716.712.0853

Insurance

Plan Participation
Southgate Medical Group participates with most insurance companies, including those listed below. Patients should be aware of their insurance coverage, policy provisions, authorizations requirements, and network providers. It is our patients’ responsibility to inform us of any changes in their insurance coverage. This includes identification number, insurance company, or group number changes.

Blue Cross /Blue Shield
Coventry Healthcare (First Health)
Emblem Health (GHI)
Empire Plan (UHC)
Fallon Health Weinberg
Fidelis
Humana – Choice Care
Independent Health – ( IHA)
Magnacare / Aetna
Martin's Point Healthcare (US Family)
Medicaid
Medicare (NGS)
Medicare (RR)
MultiPlan
MVP / Cigna
Nova ( IHA)
POMCO
Today's Options (Universal America)
Tricare
United Healthcare
Univera
Wellcare
Worker's Comp

Due to relationships between insurers, third-party administrators, and ‘umbrella’ networks, patients are strongly advised to contact their insurance carrier for participating provider information. We bill non-participating insurance companies as a courtesy to our patients. If we have not received payment from a non-participating insurance company within 60 days of the date of service, you will be expected to pay the balance. We will provide you with all the necessary information for submitting claims to your insurance company.

Referrals
Some insurance companies require a referral if you are seeking specialty care. It is the patient’s responsibility to request a referral from our office at least two weeks prior to the appointment. To provide a referral, our business staff will require the first and last name of the specialist, the specialty, and your diagnosis or reason for the appointment.

Prior Authorization
Some medical tests such as a CT scan or MRI and certain medications may require prior authorization from your insurance company. In the event that you are affected by this policy, please notify our office immediately since the authorization process may require up to one week.

For free or low cost health insurance for eligible patients: http://www.health.state.ny.us/health_care/

Billing Policies

Payment is required at the time services are rendered. Southgate Medical Group accepts cash, personal check, Visa, Mastercard, and Discover. All co-payments and past due balances are payable upon check in.
Returned checks. A service charge of $15 is required for returned checks. If there is a past-due balance, any amount paid will be applied to the past due balance first.
Late payments. Patients with an outstanding balance of 120 days or more may be discharged from the practice unless payment arrangements are made and honored. These accounts will be referred to a collection agency unless prior agreements are made with our billing service.
Financial difficulties. We encourage our patients to discuss any unexpected financial circumstances with our billing department. We realize that financial difficulties may sometimes arise and the billing department has financial hardship and payment plan forms available under these circumstances. Regardless of payment status, medical care is always available.
To speak with our billing department, please call 716-206-1595.

APPOINTMENT HOURS