On behalf of The Offices of Steven A. Bernstein DPM, FACFAS (hereinafter “health service provider” or “Dr. Bernstein”), kindly accept this disclosure in accordance with P.L.2018 c. 32, ("Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act") as it applies to health care providers and physicians. Pursuant to this new legislation, notice is required to be provided by all physicians, including Dr. Bernstein, as follows:
Pursuant to the above captioned legislation, health care professionals are required to inform patients whether or not they participate in certain health insurance plans. Please note, in accordance with this requirement, accept notice that Dr. Bernstein does not currently participate in any private health insurance plan and is not considered an “in-network” provider for such plans. Dr. Bernstein is considered an “Out-of-Network” Provider.
Pursuant to the above captioned legislation, please take notice that, upon request prior to the scheduling of non-emergency procedure(s), you may receive, in writing, the amount, or estimated amount that will be billed by Dr. Bernstein for the medical treatment and/or health care service you receive from Dr. Bernstein. This disclosure will include the associated Current Procedural Terminology (CPT) Codes associated with the service or procedure.
Pursuant to the above captioned legislation, please take notice that you may be financially responsible for services provided that are deemed “out-of-network” by your health insurance carrier, including costs in excess of, but not limited to, co-pay, deductible, and/or coinsurance (if applicable). Dr. Bernstein reserves the right to seek additional reimbursement from you for procedures or services in excess of those benefits provided by your health insurance benefits plan and/or rates of reimbursement allowed by your health benefits plan for “out-of-network” providers, in excess of, and in addition to, co-pay, deductible, or co-insurance (if applicable).
Please take notice that it is advised that you contact your health benefits plan with any questions and for further consultation on costs.
Please take notice that a physician, including Dr. Bernstein is required to provide you with the name, practice name, mailing address, and telephone number (if that information is known or available) for a health care provider providing services in conjunction with those provided by Dr. Bernstein, to the extent applicable, when that health care provider is providing the following services:
- Radiology; or
- Assistant surgeon services.
In the event that Dr. Bernstein schedules you for facility admission or outpatient facility services, please take notice that you are entitled to the following information:
- When scheduling facility admission or outpatient facility services, a physician is required to:
- Provide you with the name, practice name, mailing address,
and telephone number of any other physician whose services are scheduled at the
time of pre‐ admission, testing, registration, or admission when non‐emergency services are scheduled;
- Provide information on how to determine the health benefits plans in which the
other physician participates; and
- Recommend that you contact your health benefits plan for
consultation on costs.
Please take notice that if the status of a health care professional changes with respect to the health care professional(s) network status, including Dr. Bernstein, between the time of the disclosures and the provision of the procedure, the health care professional shall notify you of the change, if known.