health insurance formsPassaic Sleep Medicine and Neurological Services currently participate with most major insurances as well as some Medicaid HMOs. However due to the fact that these are subject to change, it is suggested that you inquire when scheduling your appointment. Although there are few instances, our office runs on a 15 minute schedule. If you think you will be late for your appointment, please call the office to see if you need to reschedule.

Copays, coinsurances and deductibles will be the responsibility of the patient. We will gladly bill your insurance company on your behalf for those insurances for whom we do not participate with, however, payment for services will be expected at the time of service. Our office is willing to work with patients who would like to set up a payment plan for any balances or services not covered by your insurance. If you are uncertain about the coverage and benefits provided by your insurance plan, please consult with your carrier prior to your visit.

If your plan requires a referral, it is the responsibility of the patient to make sure the referral is done. We can not accept a written script as a referral for most of the insurances. Please confirm with your referring doctor and/or insurance carrier to clarify their requirements. Please be advised, per our contract with the insurance companies, if you do not have a valid referral your appointment will have to be rescheduled, even if patient is willing to pay out of pocket.

You have the option to print out the required forms and fill them out prior to your visit to save time in our offices. If you prefer to complete forms at office please arrive 15 minutes before appointment. Please click on the link below for a printable form which you can print out on your own PC.

All copays are due at time of service in the form of CASH CHECK OR VISA AND MASTERCARD. If copay is not paid at time of service there will be an additional administrative cost of $15 added to your balance.


Patient Forms

Here are the forms you will need for when you visit our practice as well as information on certain procedures. Feel free to Print these forms to save yourself time upon your arrival.