*Required fields are marked with an asterisk.
NEW PATIENT INFORMATION
What You Should Bring To Your Visit:
completed forms under the “Patient Forms” tab. (Unless after you completed them, you transmitted the completed forms back to our office before your visit.)
Please go to the “Patient Forms” tab and follow the instructions given there.
credit card (Visa, American Express, or Discover) is required. Although you will not be required to use it to pay for your visit, copayment, coinsurance or deductible.
(Cash, debit cards or checks are also accepted.)
list of your present medications and dosages.
(Unless, already listed on your completed forms.)
The name, telephone number, and address (including the zip code) of
This will allow Dr. Rosenthal to electronically submit your prescriptions directly to your pharmacy.
If your insurance plan requires you to have a
referral from your doctor/Primary Care Physician in order to see a specialist, you must bring it.
In order to provide you with that referral your doctor may need Dr. Rosenthal’s provider ID number for your insurance plan:
these are listed below.
Accepted Insurance Plans:
Dr. Rosenthal's Provider ID Number:
1199 National Benefit Fund
Blue Cross/Blue Shield
HIP (Emblem Health)*
Horizon Healthcare BCBS of NJ - (PPO ONLY)
United Empire Plan
(We do not accept any GHI or Medicaid affiliated plans.)
Some Other Office Policies:
If you are insured by a plan in which Dr. Rosenthal participates, and with which you have a copayment, coinsurance, or unsatisfied annual deductible applicable to any of the services rendered to you at your visit, you will have to pay them
on the date of service.
If you do not have insurance or Dr. Rosenthal does not participate with your insurance plan, then full payment is required at the time of service.
Once we give you an appointment, we save that time slot for you, so please, if you need to cancel or reschedule your appointment, please give us at least 24 hours notice.