Financial Information
We appreciate you working with us to ensure we meet the requirements set out by your insurance company. Please let us know how we can help you!
Co-payments are due at the time of service. If you are unable to remit your co-payment amount, the office reserves the right to reschedule your appointment for another day/time that is convenient for you. If it is determined the patient needs to be seen regardless of the ability to pay the copay, the practice will bill an additional $20.00 fee if the copay is not remitted by the end of the business day.
Due to the recent increase in high deductible plans, it is now the policy of the Pediatric Center to require a $50.00 minimum payment towards any balances greater than $50 on the account. If you are unable to make the payment at the time of the scheduled appointment, we will require that you start a payment plan at the office that day for the current balance on the account. If you do not address the balance, the office reserves the right to reschedule your appointment for another day/time that is convenient for you.
- Any remaining balances, as determined by the insurance carrier will be billed to the responsible party on the account. Balances are expected to be paid promptly, within the first 30 days of receiving your statement.
Patients/parents/guardians that present at the office without health insurance will be asked to pay a deposit of $100.00 at the time services are delivered. You are very likely to have a remaining balance above the $100 payment, for which you will receive a statement. Pediatric Center expects account balances to be paid at the next appointment, or within 30 days of the bill, whichever is sooner.
If your child is here for a Well Child Visit and has significant health concerns – anything that requires additional treatment – insurance companies require us list these as separate medical conditions. These may be subject to your plans deductible. You will be billed for any remaining charges after your insurance has processed your claim.
It is the responsibility of the patient/parent/guardian to notify the office of any changes to your insurance, so that we can correctly file claims, and accurately determine out of pocket costs. It is expected that all information you provide on primary and secondary insurance(s) is accurate. Any missing or incorrect information could result in a bill being left to your responsibility.
The Pediatric Center bills insurance as a courtesy to our patients. If we receive denial information from your insurance payer, you may receive a bill from our office. It is the responsibility of the patient/parent/guardian to reach out to our billing office and/or the insurance company to discuss the balance.
Any phone number provided, at which I may be contacted, I consent to receive calls or text messages, included but not restricted to communications regarding billing and payment for items and services, unless I notify the office to the contrary in writing. Calls and text messages include but are not restricted to pre-recorded messages, artificial voice messages, automatic telephone dialing devices, or other computer assisted technology, or by electronic mail, text messaging or by any other form of electronic communication for the office, affiliates, contractors, servicers, clinical providers, attorneys or its agents including collections agencies.
If the Pediatric Center does not receive prompt payment; we reserve the right to transfer your balance to outside collections after 90 days. If an account is referred to outside collections, we reserve the right to dismiss the patient from the practice. The account is subject to additional fees related to the collections activity.
Payment is required at the time services are rendered unless other arrangements have been made in advance. This includes applicable coinsurance and co-payments for participating insurance companies. Pediatric Center accepts cash, personal check, and all major credit cards. There is a service charge for returned checks of $35.00.
Broken appointments represent a cost to us, to you and other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge a $25.00 fee for missed or late-cancelled appointment. Excessive abuse of scheduled appointments may result in discharge from the practice.