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Insurance & Payment Policy
It is your responsibility to pay your copay, co-insurance or deductible at the time of service. Payment may be made by cash, check, Visa, Mastercard, American Express, or Discover. WE DO NOT BILL FOR COPAYS.
If payment is not made by the end of business on the date of service, a $10.00 service charge will be applied to your child’s account.
You are responsible for any charges not covered by your insurance plan.
If your child has insurance that we do not participate with, or if your child does not have insurance, payment in full is expected at the time of service. If payment arrangements need to be made, those arrangements should be made prior to the office visit.
Physicals, well-child check-ups, ADHD rechecks and other elective visits may be rescheduled or cancelled if there is a past due balance on the family account that is not current on a payment plan.
The parent or adult who brings the child for care is responsible for payment due at the time of service. Please do not place our practice in the middle of divorce or marital disputes. It is your responsibility to work out payment arrangements for your child’s medical care with the other parent. We will be happy to provide you with a receipt for your payment so that any money due you from the other parent can be recouped.
We do not file secondary insurance for copayments unless your secondary plan is a Medicaid plan.
We do not accept new Medicaid patients. Our panel became closed in June, 2008. The only exceptions to this are new babies born into families who already have children who come to us or patients who have been with our practice longer than 6 months who are newly enrolled in Medicaid. When new Medicaid is presented for patients who are already established with our practice, eligibility dates will be checked to determine if the coverage was in effect during the first six months of the patient/practice relationship. If it is established that Medicaid was in effect during the first 6 months, we will request that the patient be moved to another Medicaid provider. By signing this receipt of office policies, you are acknowledging that you understand our policy on acceptance of new Medicaid patients
A $30.00 fee will be charged for any check returned for insufficient funds.
It is your responsibility to provide our office with your most current insurance information and a copy of your most current insurance card. Many insurance companies have 60 or 90 day filing limits. If current/correct insurance information is not provided in time for us to file a claim, the balance for that visit becomes your responsibility.
If your insurance plan is one that requires a primary care physician (PCP), one of our doctors must be on your card. If our practice is not listed as your child’s PCP, you will be responsible for all services rendered until the correction is made.
If your insurance company requests information from you in order to process our claims, please provide that information as soon as possible. If you do not provide the information within 30 days of the request, the balance will become your responsibility.
If you have a past due account that is turned to our collection agency, your children will be dismissed from our practice for non-payment. In order for them to be reinstated to the practice, the collection balance would have to be paid in full.
Please call us promptly if you have a question about your bill. Most problems can be solved quickly and easily. We are happy to work with you to take care of your financial obligations, but it requires that you communicate with us if there is a question or a problem.