Billing & Insurance
Our office partners with many insurance providers, including:
- Aetna
- Blue Cross/ Blue Shield Plans
- Cigna
- Empire Plan (NYSHIP)
- Excellus Plans
- Highmark BCBS
- Independent Health
- Blue Choice Option
- MVP Health Ins
- Molina Health
- United Health Care
- Univera
- Your Care
- Fidelis
Insurance Plans Not Accepted: We do not accept PHCS/Multiplan, Medicaid, or Tricare.
Note: Legacy Pediatrics is an independent practice and does not provide charity care. Please contact your insurance provider if you have questions about our participation in your health plan. We submit claims for other private plans as well, but participation may vary. Our billing office can be reached at 585-568-8330, option 6.
We are committed to offering equal access to care, regardless of insurance type.
Member of Accountable Health Partners (AHP)
Check Your Coverage: Please verify your insurance coverage for labs, X-rays, referrals, and medical visits with your provider.
Useful resources are available on this page and in the document below for further assistance.
Financial Policy
We strive to provide high-quality care and are happy to discuss fees with you. Understanding our Financial Policy is important to our relationship with you. For questions, please contact our billing office at 585-568-8330, option 6.
Patient Registration: All patients need to complete a Patient Registration form before being seen. To ensure current information, we will review it with you at each visit, and we will also scan your insurance card into our system.
Key Financial Information:
Co-Payments
Your insurance requires co-payments to be collected at the time of service, so please be prepared to pay upon check-in.
Deductibles and/or Additional Co-Payments
If your insurance requires payment through your deductible or co-insurance, you are responsible for these charges. Starting January 1, 2025, we will request a deposit (starting at $82) for services under your deductible/co-insurance plan. Please review your insurance benefits or contact your insurer for clarification. Any charges not covered by insurance must be paid in full upon notification.
Processing Fee
A $25 fee applies for co-payments or deductible deposits unpaid at the time of your visit. Persistent non-payment may lead to discharge from our practice.
Self-Pay Payments
Patients without insurance information are required to pay an upfront deposit of $160 for physicals and $110 for illness visits, with any remaining balance due at check-out.
Insufficient Funds
A $25 administrative fee applies to checks returned for insufficient funds.
Medical Records Requests
Your first request for a copy of medical records is free. Subsequent requests will incur a fee of $0.75 per page (in line with New York State rates), plus postage.
Accepted Payment Methods
We accept cash, checks, money orders, and major credit cards: Visa, MasterCard, American Express, and Discover.
Online Payments
You can use our online bill-pay portal to settle your balance.
No Show/Cancellation Policy
24-Hour Notice: Please provide at least 24 hours’ notice if you need to cancel or reschedule.
If proper notice is not given:
- First missed appointment: “Warning” letter
- Second missed appointment in 12 months: Fee equal to the missed appointment cost
- Third missed appointment in 12 months: Possible discharge from the practice
- Arriving over 15 minutes late may require rescheduling.
Contact Numbers
We may use all home or cell phone numbers provided to Legacy Pediatrics to reach the patient or guardian for the following purposes:
- Outstanding balances
- Billing or insurance inquiries
Insurance Resources
- Aetna – # on back of card or 1-800-US-AETNA (1-800-872-3862)
- Cigna – # on back of card or 1-800-997-1654
- Empire Plan – 1-877-7NYSHIP (1-877-769-7447), choose UnitedHealthcare
- Excellus – # on back of card or 1-800-499-1275
- Independent Health – 1-800-501-3439
- Medicaid NYS – Your caseworker or Medicaid Helpline 1-800-541-2831
- Your Care – # on back of card or 1-800-683-3781
- MVP – # on back of card or 1-888-687-6277
- United Healthcare – # on back of card or 1-866-633-2446
- Univera – # on back of card or 1-800-499-1275
No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, healthcare providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For Questions or More Information About Your Right To A Good Faith Estimate:
Visit www.cms.gov/nosurprises or call the Legacy Pediatric Billing Department at 585-568-8330, option 6.