Frequently Asked Questions

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We do not participate in commercial insurance, Medicare or Medicaid. Our patients can subscribe to a monthly membership plan or can choose to pay per visit for "as needed care". 

By not contracting with insurance companies, we can spend less time and resources filing insurance claims and following on reimbursement and insurance denials. This results in lower cost of patient care and more time to focus on our patients.    

Our doctors have opted out of Medicare.  If you are a Medicare patient looking to establish care with our practice, please note that Dr. Cabas Vargas and Dr. Fradlis are able to see you in the office but neither you nor your doctor can seek reimbursement from Medicare for the services provided. 

The benefits of a direct pay practice include a more personalized approach to your care.  This practice model is aimed to increased access to your doctor when you need them and to eliminate barriers to quality care. At the same it allows for reasonable pricing and no surprise bills. 

If your insurance plan mandates high specialist copays, high deductibles, or restrictions on where you can seek care, the direct pay route is almost always more convenient and has significantly lower cumulative out-of-pocket expenses than utilizing your insurance. 

Personable, Accessible, Affordable and High-Quality Care

There are multiple benefits to a direct specialty care model. Your physician will be able to provide you with the time that you deserve in order to properly and thoroughly evaluate your medical concerns. We will be able to answer your questions and provide you with the tools that you need in order to manage your unique condition. Additional benefits include shorter waiting time to see the doctor, ability to see the specialist regardless of your insurance or referral status, and access to telehealth visits when needed. 

Feel free to read what our patients have been saying about their care:

 Dr. JENNY CABAS VARGAS - Rheumatology - Goshen, NY (kareo.com) 

 Dr. BELLA FRADLIS - Rheumatology - Goshen, NY (kareo.com) 

Every insurance plan is different. We encourage you to reach out to your insurance carrier to see whether you qualify for out of network benefits and for information about the allowable reimbursement amount as outlined by your plan. We can provide a superbill for you to submit to your insurance company, but we cannot guarantee that you will receive reimbursement. You can also sign up for Reimbursify, an app which can guide you further about this process*.

* Amount reimbursed might not be same as what you paid in the office. Payment is based on your out of network benefits and the amount allowed to physician services by your plan. Please check with your insurance directly.

Yes. We are able to co-manage with your traditional fee-for-service rheumatologist and will provide you with consultation services/second opinion evaluations as needed. 

Having a credit card on-file is not uncommon in medical practices. This helps to reduce patient no-show rates and serves as a convenient, touch-free option to pay for your visit. We will never charge your credit card for anything other than your membership fee or pay as you go visit. No surprise bills or charges. 

We accept the following forms of payment: 

- Cash

- Check

- Zelle

- Credit cards (VISA, Mastercard, American Express, etc.)

- Health Saving Account Funds

- Flexible Spending Account Funds

Not a problem. Please let us know 30 days ahead of time. We will be able to reinstate your membership in the future if you choose to return to the practice, however there will be a $100 reactivation fee.