We participate with many insurance plans and we will file those insurance claims for you. In order to file your insurance for you, we must have a current copy of your insurance card on file. It is your responsibility to inform us of any changes in your insurance.
We recommend that you verify whether your insurance covers well child visits and immunizations.
Please remember that your insurance policy is a contract between you and your insurance company and we are not a party to that contract. Even though insurance may be filed, all bills are payable upon receipt and you are ultimately responsible for the payment of all services. You may request to set up a payment plan if the balance owed on your account exceeds $100.00.
All co-pays, co-insurance, and deductibles are due at the time of service.
- CASH - No bills larger than $50.00 are accepted for co-pays.
- PERSONAL CHECKS - We must charge a fee, which is posted in our reception area, for any returned checks.
- CREDIT CARD PAYMENTS - Visa, MasterCard, and Discover may be used in the office or ONLINE at https://pay.instamed.com/kidschoicepeds.
SELF-PAY/OUT OF POCKET PATIENTS:
Please be aware a Good Faith Estimate will be provided to you at your request and/or within 1-3 days once services are schedule, if applicable. Due to the nature of the practice, sometimes these services are on an as needed/seen basis but, we will do our best to accommodate you in the time frame required by federal law. Please see the following fee schedule when determining your possible cost. Upon arrival to each appointment, a $50.00 payment will be required before the patient is seen. Once the appointment is completed, we will collect the remaining balance for that day’s visit. We offer a 20% discount for services when the full balance is paid on the date of service. If, however, you are unable to pay the balance in full on the date of service, the 20% discount is forfeited and payments must be made). Payment plans are strictly enforced and, if payments are not made on a monthly basis, may result in your account being turned over to a collection agency and your child(ren) being discharged from our practice.
If the balance on your account or monthly payment (if you are on a payment plan) exceeds 30 days past due, a $15.00 Late Fee will be assessed to the balance owed. In the event that a past due balance is turned over to our collection agency, the patient/guarantor will be responsible for all fees incurred, including but not limited to court cost and legal fees. In addition, the patient/family will be discharged from the practice.
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an
in-network hospital or ambulatory surgical center, you are protected from
surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs,
such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to
pay the entire bill if you see a provider or visit a health care facility that isn’t in your health
plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your
health plan. Out-of-network providers may be permitted to bill you for the difference between
what your plan agreed to pay and the full amount charged for a service. This is called “balance
billing.” This amount is likely more than in-network costs for the same service and might not
count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is
involved in your care—like when you have an emergency or when you schedule a visit at an in network
facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out of network
provider or facility, the most the provider or facility may bill you is your plan’s in network
cost-sharing amount (such as copayments and coinsurance). You can’t be balance
billed for these emergency services. This includes services you may get after you’re in stable
condition, unless you give written consent and give up your protections not to be balanced
billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain
providers there may be out-of-network. In these cases, the most those providers may bill you is
your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia,
pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist
services. These providers can’t balance bill you and may not ask you to give up your protections
not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance
bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also
aren’t required to get care out-of-network. You can choose a provider or facility
in your plan’s network.
When balance billing isn’t allowed, you also have the following
protections:
• You are only responsible for paying your share of the cost (like the copayments,
coinsurance, and deductibles that you would pay if the provider or facility was in-network).
Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in
advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in network
provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services
toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact Amber Keeble, Office Manager, by
way of email at manager@kidschoicepeds.com.
Visit cms.gov for more information about your rights under federal law.