FINANCIAL POLICIES
+ ACCEPTED INSURANCE We accept most insurance plans. You can find more detailed information under the FAQS link.
If you are not covered by an insurance plan we accept, full payment is expected at each visit. If you are insured by a plan we do accept, but find their system states your coverage is termed for any reason, payment in full for each visit is required until we can verify your coverage. Once coverage can be verified, claims will be resubmitted and upon receipt of insurance payment, a refund will be issued to you.
+ CO-PAYMENTS / CO-INSURANCE
Co-payments and co-insurance must be paid at time of service. These arrangements are part of YOUR contract with YOUR insurance company. Failure on our part to collect the patient responsibility payment, at the time of service, can be considered fraud.
+ NON-COVERED SERVICES
We believe that the supplies and / or services listed below are an important part of your child’s care. We recommend that you receive these supplies and / or services in our office in order to provide your child with the best care possible. School forms require some of these services.
Please be aware that some services you receive may be considered non-covered by your insurance carrier. You are obligated to pay the “patient responsibility” portion for these services. Each insurance carrier has hundreds of different insurance plans; therefore, knowing your benefits is YOUR responsibility.
Please be aware that our billing department is not responsible for knowing what YOUR specific plan will or will not cover. We have been contracted with certain insurance carriers and must follow what is allotted on the patient’s Explanation of Benefits. Any patient responsibilities “write off” is considered fraud, therefore, if the Explanation of Benefits states a patient balance, we are obligated to collect that balance by law.
§ To help you determine what is a covered service is and what is a non-covered service, we suggest you call your insurance company directly.
+ PROOF OF INSURANCE
All patients must complete our patient insurance form at the time of appointment. A copy of your current insurance card must be on file before we submit claims to your carrier. It is your responsibility to notify us within 30 days with any change of insurance. If you have more than one insurance please provide all insurance plans that you are a member of . If you do not do so, it will result in a claim denial as the insurance companies will find out that you have another plan that may be responsible for part or the entire visit fee.
+ CLAIM SUBMISSION
We will submit your claims and 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 claims is your responsibility whether or not your insurance company pays your claim. Your insurance benefits are contracted between you and your insurance company. WE ARE NOT a party to that contract. Insurance carriers will not accept any claims submitted after 90 days, therefore, it is imperative we have accurate information prior to submitting your claim to avoid any delay.
Secondary Insurance: As a courtesy, we will submit to a secondary carrier.
+ RETURN CHECK
Our return check fee is $20. After two bounced checks, patients are required to pay with cash only.
+ MOTOR VEHICLE ACCIDENT CLAIMS
Motor vehicle accident claims are covered by No-Fault Insurance. It is YOUR responsibility to notify the carrier involved and submit our bill to them. We will complete the NO FAULT CLAIM form once we receive it from your carrier. It is your responsibility to follow up with the insurance carrier if payment is not received within 45 days at which time it will then be considered a Patient Balance.
+ NON-PAYMENT
It is our office policy that patient balances must be paid in full prior to scheduling any well appointments. If your account is 90 days past due, you will receive a letter stating that you have 10 days to bring your account current. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and your immediate family members may be discharged from this practice for non-payment. If this should occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During the 30 day period, we will treat your child for sick care only.