Billing Policies

Patient co-pays due at the time of service  In 2017, most insurance companies will increase family contributions in the form of large yearly deductibles  and higher co-pays. Co-pays are due at the time of service.  If you have a deductible, please try to pay at the time of service. If you prefer to wait until you receive you Explanation of Benefits (EOB) from your insurer, the patient responsibility portion is the amount due to us.

Responsible party for payment  The responsible party will pay the fees for services rendered. Payment is expected at the time of visit. You may pay by cash, MasterCard, Visa or Discover. In the cases of divorced parents, we do not involve ourselves in intra-family disputes regarding the financial responsibility of a bill or account. In cases of dispute, the parent or person who brings the child to the office is considered responsible. All co-pays must be paid at the time of the child’s visit regardless of who accompanies the child.

Multiple insurance policies  If you have more than one policy or your child is insured by more than one parent, you must let our office know. We will need copies of all insurance cards. You will also need to contact your insurance companies for a Coordination of Benefits to ensure your child’s visits are paid for by the correct insurance.

Statements and Collections   Your insurer’s EOB explains how your benefits were applied to a claim. The EOB includes date of service,  amount billed, amount covered, amount paid and any balance you’re responsible for paying us. After receiving your EOB, you can pay us through our online bill pay, call the office to make arrangements or mail a check. We will send statements every 4-6 weeks. If your balance is not paid after 60 days, you account will go to collections and a 25% service fee will be added.

Adding a new child to your policy  You will need to notify your insurance carrier of your newborn or adopted child. The effective date of insurance must be on or before the child’s first visit at our office. Your policy may require you choose a PCP which will need to be added. If your insurance denies claim reimbursement as the result of patient not added to policy within the required time-frame, improper PCP designation or effective coverage date, the claim will become your financial responsibility.

HIPAA compliancy  Please review the Practice Agreement (HIPAA privacy and billing policies). Your signature on the Consent form you sign at the time of check-in confirms you have read and understand these policies.

Insurance Plans

Blue Cross Blue Shield (HMO, POS, PPO)                         PHCS                                         Amerigroup
United                                                                                        Great West                               Wellcare
United-Golden Rule                                                                Humana                                    Medicaid
Aetna                                                                                          Coventry
Cigna                                                                                          TriCare

We are in-network with most major insurance companies. Because insurers can change plans and their network affiliates annually it is your responsibility to find out if we are in-network with your plan.  If we are not, we can bill you as an out-of-network provider.

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