Payment for Services: Charges for services are described in our fee schedule which can be obtained upon request. For your convenience we accept Visa, MasterCard and Discover Card. It is important that you become familiar with the provisions of your insurance coverage. Coverage varies with all insurance plans and cannot be guaranteed. Some plans only cover services rendered at certain hospitals, labs and outpatient facilities. IT IS YOUR RESPONSIBILITY TO KNOW IF YOUR INSURANCE COVERS WELL EXAMS AND IMMUNIZATIONS AND WHAT AMOUNT THEY COVER. Many times they provide limited benefits on these services. If our office has to call your insurance company regarding benefits we cannot guarantee the benefits that are stated to our staff. You will be responsible for all non-covered services rendered at our office at the time of the service.
WE WILL SUBMIT CLAIMS FOR INSURANCE COMPANIES THAT WE ARE CONTRACTED WITH. Payment is required in full at the time of check-in for all copays, deductibles, and past due balances. There will be $10.00 fee assessed for any copay/balance not paid at the time of service. We will not be able to see your child if you are on an HMO plan that we are not contracted with. You must see the provider listed on your card. We may be able to see you if it is a PPO/EPO or indemnity plan ONLY. You will need to submit the claim directly to any non-contracted insurance plan. Payment is due IN FULL at the time of check out. You can obtain a copy of your itemized bill at the time of the visit. It will contain a complete itemization of medical services rendered, diagnosis, charges and other information required by your insurance carrier. It serves as the "Attending Physician's Statement" portion of your insurance claim. Therefore, DO NOT SEND CLAIM FORMS TO THIS OFFICE.
If you have percentage plan that we are contracted with we will bill them. You are responsible for payment of your account within 45 days of the exam. If you are in for a visit prior to a statement being generated for your balance you will still be required to pay the full balance at the time of check-in. If a charge is determined by the insurance company as patient responsibility for any reason, payment is due in full. If you feel in any way that there is an error, you may dispute it with your insurance company. If the claim is then reprocessed and paid by your insurance company you will be reimbursed the approved by your carrier.
We will bill your secondary insurance as a courtesy, only if we are a contracted provider. If payment from your secondary is delayed by your insurance company over 60 days for any reason it is your responsibility to make payment arrangements on your account.
You are required to fill out complete paperwork once a year, or whenever there is a change in insurance or address.
We charge a $25.00 fee for returned checks. If you have more than three returned checks you will be required to pay by cash, money order, or credit card for all future services.
If you have any questions regarding your account, please call our Billing Department at 602-978-2500, and choose option 6, M-Th, 9am - 12noon and 1pm - 4pm and closed on Fridays. |
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