Billing and Payment Policy Get to know our office
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Billing and Payment Policy


We participate with many insurance plans both Private and Medicaid. However, insurance plans change, so we ask you to know your benefits (copays, deductible, network, covered services, etc.) and to bring your insurance card to each visit. If your insurance changes, please notify us before your next visit. If there is a lapse in insurance coverage, you will be expected to pay in full at the time of service for all appointments until insurance coverage is reinstated.


It is your obligation to pay your co-payments, estimated deductibles and coinsurance, and non-covered services at the time of service per your contract with your insurance. The responsible party who brings the patient (mom, dad, grandparent, aunt, etc.) into the office is expected to pay at check-in. Please contact your insurance company to determine deductible and other amounts prior to your appointment.

Claims Submission

We will submit your claims and assist in any way we can to get them paid. Your insurance company may need additional information from you directly. Please provide this information promptly. Please be aware, any unpaid balance (copays, deductibles, coinsurance, and non-coveredservices) is your responsibility.

Divorce/Shared Custody

Child custody arrangements have no impact on insurance. The parent/guarding who brings the child into the office is expected to pay the charges due for the service rendered that day. Sunshine Pediatrics does not participate in payment disputes between parents.


Unless it is a medical emergency, before scheduling an appointment for your child, you will need to pay off any outstanding guarantor balance or enroll in a payment plan.

Sick Care during a Well Exam

If in the course of a patient’s well exam a separate, non-well issue presents which needs to be addressed, it may be addressed during the current visit or at a subsequent visit. If addressed at the time of the current well exam, an additional E&M code(evaluation and management) will be added to the visit. Your insurance company may require second co-pay or a deductible may apply for the additional service or procedure. Sunshine Pediatrics of Florida will file your claim. If the EOB (explanation of benefits) shows an additional amount is owed by the patient, you will receive a bill for that amount.

Vaccine Payment Policy

Please note IF your insurance company charges a copay for a Shot Only visit you will be responsible for paying this copay at the time of the visit. Any patient balances that may be linked to your account will be due at the time of the visit as well.