INSURANCE and BILLING

INSURANCE Current Insurance Plans: We are currently participating providers in Empire Blue Cross and Blue Shield, Anthem Blue Cross and Blue Shield, United and Oxford Health Plans, Pomco, GHI, Cigna, Aetna, and Insurance covered by Multiplan.   If We Don't Participate: Our office secretary can tell you if other insurance plans are being considered by our practice or are pending. If we do not participate in your plan, you will receive an itemized statement that has been signed by a physician at the time of each visit. This bill should be attached to the standard claim form issued by your insurance company and mailed directly to them. Do not return it to us for processing. Claim forms can be obtained from your insurance company, your employer, or in some cases, from our office. Read Your Insurance Contract Carefully:  In some cases, physician services require a co-payment at the time of services, or there may be no reimbursement until a deductible amount has been reached. Also, some carriers may only make payment if medical and diagnostic services are ordered or provided by their participating doctors; if they are performed at specific locations; or if they have received prior approval from the carrier. Our bookkeeper can provide additional information if it is needed. BILLING FOR SERVICES Parents are expected to pay for office visits and co-payments at the time of each visit unless other arrangements have been made in advance. Statements of account are mailed monthly and are payable upon receipt. Credit card payments made in person or by telephone are acceptable. If you have questions about fees charged for service, please contact our bookkeeper as early as possible. Alternate payment arrangements are available for our patients when personal or financial problems arise. At times of need, we will discuss them with you. FEE SCHEDULES A complete fee schedule is available from our secretary. Fees may change from time to time without prior notice. A modest surcharge is added for Sunday, holiday, and after- hours visits. NEW ADMINISTRATIVE FEES AS OF OCTOBER 1, 2011. CANCELLATION FEES: There will be charge of $50.00 for missing a scheduled appointment or for canceling an appointment less than 24 hours in advance. This fee applies to appointments scheduled for physical exams and consultations, not to appointments for sick visits. Unlike other practices, we have not in the past charged for missing or canceling appointments. If you need to reschedule a long-standing appointment, we appreciate your consideration, informing us more than 24 hours in advance. FEES FOR FORMS: There will be charge of $10.00 for completion of a medical form other than at check-ups. Forms brought to physical examination appointments and simple forms requiring only a signature will be completed at no charge. Multiple forms for one patient will be completed for $10.00 total if brought all together at one time. The Universal Form provided to you at physical examination visits should be kept by you. Copies of that form can conveniently be attached to forms from schools, sports, and camps -- usually no supplemental information is required. If the Universal Form is lost, it will be replaced for $5.00. FEES FOR RECORD TRANSFERS: If you request copies of your medical records to be sent to another physician, there will be charge of $0.75 per page, plus the applicable fees for mailing. We appreciate your understanding of these fees, largely necessitated by economic conditions.