We will attempt to verify insurance eligibility at the time of service; however, due to the nature of insurance plans, it is the patient’s responsibility to check with their insurance company beforehand to ensure that we are an in network provider.

1. Your insurance plan is active.
2. We are in-network with your specific plan.
3. The Primary Care Provider (if applicable) is set correctly to one of our providers.
4. The insurance company does not have any other insurance policy listed as primary. If you have secondary insurance please ensure both insurances are aware of each other (coordination of benefits). Failure to do this prior to your appointment may result in a patient balance.
5. If there are any issues verifying the insurance prior to the appointment or if coverage is denied by your insurance we will be charging a self pay fee. For patient’s with Medicaid insurances, self pay rates will be calculated per our fee schedule. For Private insurances, self pay rates will be calculated at 60% of the total bill fee.

Newborns must have active insurance coverage and/or an appropriate PCP listed on file to avoid paying a self pay rate (non refundable). For commercial insurance plans, you must contact your insurance carrier as soon as possible after your child is born to activate their coverage prior to this appointment. This step is required prior to the visit as our office is not allowed to bill the insurance directly if you fail to activate the patient. Please be aware that most plans only allow for this step to be completed within 30 days of birth. For Medicaid insurance plans, you must contact the Medicaid office at (877) 711-3662 to activate your newborn’s coverage and designate a provider in our facility as the primary care provider (PCP).

Please note that there will be a $25.00 No-Show fee assessed to the patient’s account following a missed appointment. Payment of fee will be due at the following office visit. We truly appreciate your understanding and your cooperation and are grateful you are our patient. We look forward to a long and healthy relationship.

Preventative Care and Additional Copays Even if a preventive test or screen is fully paid by insurance, you may still receive a bill for a copay or co-insurance for the office visit. For most private insurances, the Preventive Care Visit, which includes a routine physical exam and immunizations does not require a copay. However, even if a preventive test or screen is fully paid by insurance, you may still receive a bill for a copay or co-insurance for the office visit. Although preventative care is free it is possible you will still be responsible for a copay if acute problems or chronic diseases outside of the scope of a Well visit were addressed during the visit as this would then be considered “diagnostic” instead of preventative.

All payments/co-payments and DEDUCTIBLES are to be paid up front at the time of office visit. This arrangement is part of your contract with your insurance company. If you are paying with a check, please include, if applicable, the patients name in the memo line of the check. Please note, refusal to pay any owed balances or copays can cause delay in your child’s care as your appointment may have to be rescheduled unless the patient is requiring emergent attention at the time of the visit. Please note in the case of recurrent declined payments we will terminate the payment plan and you might be ineligible to set up future payment plans.