Important Information
Allergy Visit Insurance Guide
We will make every effort to review your insurance information prior to your visit. However, the information we receive may not always have your most accurate and/or up-to-date benefit coverage details, therefore, we strongly recommend that you contact your insurance provider to understand what is covered by your insurance plan prior to coming for your first visit.
To obtain this information, you will need:
- Your insurance card (member services phone number can be found on the back of your card)
- Name and DOB of the insurance policy holder
- Name of your allergist: Dr. Rushita Mehta
- Office address for your allergist: 715 Park Avenue, Suite 2 New York, NY 10021
When you call member services:
- Let them know that you are planning to visit an allergy specialist, Dr. Rushita Mehta, at Avant Allergy & Asthma
- Confirm that we are in network with your insurance plan
- Inquire about coverage for the following:
- Office visit with an allergy specialist
- Allergy testing performed in the office
- Allergy shots and treatment (allergen immunotherapy—AIT)
- Breathing tests in the office
- Expedited immunotherapy
** if you are subject to a deductible, you may want to request contracted prices for such services
Below are some commonly used codes that may apply to your visit:
- New patient visit codes: 99203, 99204
- Allergy testing codes: 95004, 95024, 95044
- Breathing test codes: 94010, 94060
- Allergen Immunotherapy (AIT) shot administration: 95117
- AIT serum/vials: 95165
- RUSH (expedited) immunotherapy: 95180
Commonly used insurance terminology:
Coinsurance: The amount you pay to share the costs of a covered health care service after your deductible has been paid. This is calculated as a percentage of the allowed amount for the service. For example, if your coinsurance is 20%, your insurance will pay 80% of the claim and you will pay 20%.
Copayment: One of the ways you share in your medical costs. You pay a fixed amount for covered health care services (e.g. $20 copay for every doctor visit) while your insurance pays the rest. The amount can vary by the type of covered health care service.
Deductible: The amount you pay annually for health care services before your insurance company starts to pay its share. For example, if you have a deductible of $1,000, you will pay the first $1,000 of covered services yourself before your insurance plan will start covering its share of your bills.
Network: The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services.
Out-of-pocket maximum: The most you pay during a year of coverage before your health insurance plan begins to pay 100% of the allowed amount for the remainder of the year. This does not include your regular premiums.
