Insurance contracts are between a patient and their carrier. As a medical provider, we are not a party to this contract. Although we attept to verify coverage for services we provide, we cannot guarantee what your policy will pay for. It is your responsibility to contact your insurance carrier regarding what services are covered, what your maximum allowed amount is, and what your portion will be.
Primary and Secondary Insurance
Our office bills primary insurance only. If your child is insured by Medicaid and another insurance carrier, Medicaid is the secondary insurance.
As the parent or legal guardian, you are responsible for payment of all medical services provided to your child. Health insurance serves as a form of payment, but does not replace your financial responsibility. If your insurance carrier has not paid their portion within 60 days, the full balance will be your responsibility.
Your portion of your bill, including copays, coinsurance, deductibles and non-covered services are due at the time of service. You may pay your bill with cash, credit card, a health payment card, or by leaving a credit card on file. Personal checks are not accepted. Payment is due by the person or parent who brings the child in, regardless of divorce decree arrangments. Payment plans for sick visits are available for families with financial hardship. Payment plans require a credit card on file until the balance is paid, and must be completed within 90 days.
Failure to pay your bill will result in the full balance being sent to a collection agency. The parent or legal guardian is responsible for all fees associated with collection efforts, including but not limited to, collection agency fees of 25% and attorney fees. Services will not be provided to any family members on the account until the balance has been paid. In the event that your personal check is returned due to non-sufficient funds, there will be a $35 non-sufficient fund charge, and from that point on, checks will no longer be accepted.
Sick Charges with a Well Visit
Illnesses, injuries or significant problems addressed during a well exam require additional time and medical decision making. These services will incur a separate charge in addition to your child’s well exam. You will be responsible for your office visit copay, co-insurance or deductible. ADHD, asthma, ear infection, sore throat, skin conditions, injuries and pain are some, but not all, conditions that may incur an additional charge.
Self Insured and Health Exchange Policies
We are happy to accept self-insured policies and plans purchased through the health exchange. These plans must be paid through the end of the current month in order for us to accept the insurance as a form of payment. If the plan has not been paid through the current month, payment will be due in cash or credit card at the time of service, and we will not bill the insurance carrier for that appointment.