Billing & Insurance

Insurance plans that we participate with include the following:

  • Aetna
  • Rochester Blue Cross/Blue Shield (All PPO contracts)
  • CIGNA
  • Medicare
  • MVP    
  • Lifetime Benefit Solutions
  • Some United Health Care Plans
  • Several other insurance plans

Please note: If you are a participant of an HMO, you need to have one of our doctors listed as your OB/Gyn doctor along with your primary care (internist) doctor.  If this is not done, your claim could be rejected and you will be responsible for the bill.

We are providers for the Women’s Health Partnership (Monroe County) and other NYS Healthy Women Partnerships. For information on screening services in other counties, visit the DOH website.

If you have any questions about the insurance plans we participate in, you may reach our Billing office at 585-244-4360. We will be happy to speak with you.

Avoid surprises in your medical bills:

  • The “No Surprises Act” is federal legislation that addresses billing when patients get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center.
  • Federal law requires all providers to provide a good faith estimate to uninsured individuals or individuals who choose not to have their insurance billed for all medical items and services.
  • New York State law: You are protected from surprise billing under New York State law

About Insurance

Women who have recently had a baby or surgery, and will be out of work for some time as a result of these conditions, may be eligible for New York State Disability (NYSD). Most employers are required by state law to provide insurance coverage for these Disability Benefits. Some women may also have private disability policies that provide benefits after childbirth or surgery.

Steps to Take

To file for Disability Benefits, you will need to obtain the necessary forms from your employer’s Personnel Office or HR Department. Disability claim forms usually require information and signatures from you (the patient), your employer (including recent wage information), and your doctor (Women Gynecology and Childbirth Associates, PC). Please bring these forms to our office at least one week before your due date or surgery date. Please do not give these forms to your doctor; you may leave them for the Disability Secretary at the Front Desk.

As a general rule, disability forms should not be submitted more than two weeks before your disability begins (surgery date, or deliver date) to avoid denial by the insurance company. A denial may delay the receipt of your benefits and may require that you resubmit your forms. If your claim is denied, please contact our office immediately so that we can work with your insurance company to resubmit updated forms, if necessary.

Filling Out the Forms

You must fill out the portion indicated for “Claimant Information.” – Part A. If you are given a standard DB-450 disability form, question #7 must be answered, or your disability benefits may be delayed. Download and print a copy of the DB-450, if you need one.

For pregnant patients, once you have delivered your baby, you should receive a supplementary form from your insurance company. Please bring or send that form to our office so we can update the information we have already given them (i.e. your delivery date and type of delivery). Additionally, if you had a baby boy and he had a circumcision, please call or send a note to our office with his full name, insurance company including contract number, and the name of the subscriber on the contract.

Please contact your insurance company to add your baby to your contract. Most insurance companies require that your baby be added t within 30 days of birth, to pay claims for these services. If you do not add your baby to an insurance policy, you may be responsible for the baby’s bills and your claims may be denied.

Other Information

In the event your disability needs to be extended, a note from your doctor will be mailed to you, which you must then forward to your employer. You need to be aware that if your insurance company does not agree with our medical opinion for the extension, you may not be paid.

Please note, your sick time is not considered to be part of your disability. Physicians can not give an excuse for sick time extensions.

The insurance company typically covers:

  • Six weeks after delivery for a normal vaginal delivery
  • Six to eight weeks after a cesarean section delivery (Some companies do not pay the eight weeks for the cesarean section.)
  • Some policies cover 1-2 weeks before delivery, please check with your employer to determine these benefits.

If your company employs over 50 full-time employees you may want to inquire about your rights under the Family Medical Leave Act (FMLA).

If you have any questions, please call our office and ask to speak with the secretary who handles Disability insurance. We are here to help.

Office Policies

Late Arrival Policy

If you arrive more than 15 minutes after your scheduled appointment time you may be asked to reschedule your appointment for a different date and time.  We make every effort not to disrupt the scheduled time of our other patients.

CoPays/Deductibles

The physicians at Women Gynecology and Childbirth Associates would like to inform you that if you discussed anything “above and beyond” a “routine” annual examination with your provider, or if you had other services (for example ultrasound, DXA scan, or a provider consultation during a diagnostic exam), there may be an extra co-payment applied to your claim, as required by your insurance company.

An annual examination consists of a complete breast exam, heart and lung check, gland check, pelvic exam, and pap smear, and rectal exam if indicated. 

What to expect at your Annual Well-Women Exam

Providing time to discuss other issues during an annual exam is an opportunity that we gladly give to our patients. Our providers feel that our patients should not be inconvenienced by having to make multiple trips to our offices to discuss these other issues.