Insurance
PATIENT FINANCIAL POLICY
Insurance
IF YOU DO NOT HAVE YOUR CURRENT INSURANCE CARD WITH YOU AT THE TIME OF
YOUR VISIT, YOU WILL BE
REQUIRED TO PAY IN FULL OR RESCHEDULE FOR A TIME WHEN YOU HAVE YOUR
INSURANCE CARD WITH YOU.
The patient is expected to have the proper insurance information in
order prior to the visit. This includes listing the office PCP. Patients
who fail to present this information will asked to pay in full or
reschedule the visit.
Please bring your child's health insurance card
with you for each visit. Keeping us updated on any changes, (i.e..
address, phone number, etc.) will ensure a smooth process for
communication and billing procedures.
If your child is in need of hospitalization, lab
work or specialist care, it is very important that you know where you
are permitted to go according to your insurance guidelines.
Co-pays
The patient is expected to present an insurance card at each visit. All
co-payments and past due balances are due and payable at the time of
service.
Self-pay accounts
Self-pay accounts are patients who are covered by insurance plans that
this office does not participate in, patients without an insurance card
on file, or at the time of service, do not meet the deductible. It is
expected that payment is required at time of service for all services.
Non participating insurance plans
The financial obligations of the patients who are insured by carriers
that the practice does not participate with are considered a Self-pay
account. The insurance company will reimburse the patient on
non-assigned claims. If the office receives payment for a non-assigned
claim, the patient will receive a refund within 10 days.
Divorce cases
In cases of divorce, the individual who brings the child in, is
responsible for payment of copays, coinsurance and nonparticipating
insurance balances at the time of service. We will not bill a
divorced spouse for the patient's service.
Referrals
If your insurance company requires referrals be made, contact the office
for assistance prior to your appointment. Due
to contractual obligations with your insurance company we will not be
permitted to back date a referral date.
This financial policy helps the office provide quality care to our valued
patients. If you have any questions please contact the Billing Office at
1-216-383-0100.
AUTHORIZATION TO
CONSENT FOR TREATMENT OF A MINOR
Authorization to Release Healthcare Information
Records Release Form: From Comprehensive Pediatrics
Records Release
Form: To Comprehensive Pediatrics
Office Policies
A charge of $50.00 will be assessed to your
account if you "no show " for an appointment. If you need to cancel
an appointment we request 24 hours notice. A charge of
$25.00 will be assessed if you "no show" for a scheduled nurse
visit.
If a family member or friend is
bringing your child to an appointment without the parent, please send a
written authorization or fax the authorization to 440-871-5610 prior to
the visit. This authorization should include the date, child's
name, caretaker's name, permission to authorize medical treatment and parent signature.
There is a $10.00 charge to prescribe and
call in antibiotics for positive strep test results done at another
facility.
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