Insurance
PATIENT FINANCIAL POLICY
Insurance
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.
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.
Extended payment arrangements
for procedures exceeding $300: 75% of the total fee from an office visit
is to be paid at the time of service. The remaining balance is to be
paid over the next three months in equal monthly payments due by the
first of every month. Patients who fail to make a monthly payment will
be sent to a collection agency and maybe terminated from the practice.
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.
Patient refunds
The following criteria must be met prior to issuing a patient refund:
The patient has not been seen in the office for 90 days, there are no
outstanding insurance claims on the patient's account, and there are no
outstanding patient balances on the account.
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.
Child custody cases
The parent with primary custody is usually the parent with whom the
child lives and who usually brings the child to the office for care. The
custodial parent is responsible for payment at the time of service
whether the account is considered self-pay, participating insurance, or
non-participating insurance. If the non-custodial parent carries the
insurance on the child, the office will bill the insurance company. The
office does not get involved with divorce specifics, e.g., one parent
pays 80% and the other 20%. It is the parents' obligation to work out an
arrangement themselves or through the court systems.
Referrals
If your insurance company requires referrals be made, you are required
to notify the referral department before you to the appointment. If you
visit the ER or Urgent Car department over the weekend, you must contact
the office the following Monday. For all referrals you must speak with
the referral department. The physicians do not place the referral. Due
to contractual obligations with your insurance company we will not be
permitted to back date a referral date.
This financial policy help the office provide quality care to our valued
patients. If any questions or need clarification of any of the above
policies, please feel free to contact us.
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COMPREHENSIVE PEDIATRICS REGISTRATION FORM
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COMPREHENSIVE PEDIATRICS PATIENT CONSENT FORM
Records Release Form: From Comprehensive Pediatrics
Records Release
Form: To Comprehensive Pediatrics
Office Policies
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 and parent signature.
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.
At
times, the providers may stay in the office after regular business hours
to see sick children. There is an additional charge for this
after-hours service which will be billed to your insurance company.
The patient is not responsible for this charge.
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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