We will need to have your child’s legal name for all insurance and medical records. Please ensure that if your policy requires you to list a PCP (Primary Care Provider) on the enrollment form, that you list one of our doctors. If you do not list one of our physicians, the insurance company may deny payment of any claim. We will ask for your current insurance card at each visit to ensure that our information is correct.
If you have a deductible or co-pay, we will collect this amount prior to the time of service. Sometimes, there may be a balance on the account after insurance has paid. Any outstanding balance is due by you. Please understand (and this is the “sticky point”) that it is the Responsible Party’s responsibility to be aware of the patient’s insurance benefits, not Pediatric Affiliates. There are times that not all services provided by our office are covered by all insurance plans. For instance, some insurance plans do not cover well-care visits or vision tests (even if your child has problems seeing).
The insurance company may have limits on how many of the well-care benefits may be used. If your plan does not cover well care visits, immunizations, or has other specific exclusion, we may ask you for a deposit for these types of services. If services are not covered, under some instances, we do have a fee (which has been somewhat reduced) for this situation. Please ask us about our “Flat Fee” if a well visit is not covered.