Payments: It is our policy to collect the appropriate payment due from the patient at the time the service is rendered. This may only be your copayment, deductible, and/or coinsurance, but we do ask for payment at the time of your visit. We accept all major credit cards.

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Claims: We submit all claims/charges to your insurer and strive to assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

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Well Visits: Well visits are typically covered 100% by most insurance companies. However, all services recommended by the American Academy of Pediatrics and Bright Futures may not be covered for your child’s well visit. This includes but isn’t limited to hearing screens, vision screens, and routine labs. Please note if your insurance doesn’t cover these services for your child’s well visit, you will be required to make payment . Additionally, if concerns are addressed outside of your child’s Well visit you may incur a copay, deductible or coinsurance depending on your insurance plan.

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Sick and Other Visit: Insurance companies typically only classify visits as preventative (well) or office (sick/follow-up/other). Please note that follow-ups are deemed as office visits. Your physician may recommend a follow-up based on your child’s medical condition, including an asthma follow-up, adhd follow-up, weight checks, lab follow-ups, etc. All co-pays and other requirements for an office visit, per your contract with your insurer, will apply.

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Newborn Period: The Bright Futures guidelines, which have been endorsed by the American Academy of Pediatrics, recommends that newborns have 2 well visits within the 1st month of life. This occurs within 2-3 days of discharge from the hospital and within 2-3 weeks of the initial visit. However, you may be required to return to the office for weight checks and follow-ups on any concerns. These visits will be deemed office visits (non-well visits) or sick/other visits on our schedule. Please be mindful these visits may require a co-pay or associated fees with an office visit, per your contract with your insurer. You must pay these fees in full at the time of your visit. Additionally, it is very important that you call your insurance company to have your newborn placed on your insurance before being seen in the office. If we are unable to verify that the baby is on the policy, you will have to be Self-pay.

 

Self-Pay: All self-pay patients are expected to pay fees upfront.  The fee could change, depending upon the services rendered at the time of care.  New insurance must be supplied and showing active within 30 days of your self-pay visit in order to be reimbursed.

Self-Pay Agreement Form

 

It is imperative that you know your children’s eligibility status as well as their covered benefits. Although we are happy to supply you with an estimate of your child’s visit, it is a good idea to check with your insurance or employer as to what your family’s covered services are and your potential responsibility.

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