Billing FAQs

Is there an additional charge when my child is seen on a Saturday?

Yes, there is an additional charge of $15.00 when a patient is seen on a Saturday. This amount is filed with your insurance company and is often a covered benefit. Please call the business office if you have specific questions regarding this.

What if I am in a divorce situation and believe my former spouse is responsible for the balance?

Statements are sent only to the guarantor. The guarantor is defined as the parent/person who provides the primary residence for the child. The guarantor can be different than the main insurance policy holder. The guarantor is pulled from the patient information sheet completed in our office. If the guarantor believes a former spouse is responsible for a balance, the guarantor must forward the statement to him or her.

What is a conveyance payment?

You will see this reflected if we've needed to rearrange payments amongst your children. For example, if John has an overpayment of $10 and Sallie has a balance due of $10, we can move John's overpayment to cover Sallie's balance. Your statement will then reflect positive and negative conveyance payments.

What is a discount or adjustment?

Our physicians contract with many different insurance companies. As part of these contractural arrangements, we are required to discount the cost of the services for those charges noted as over the reasonable and customary. This differs from an uncovered benefit, which is most often entirely the patient's responsibility. Any discount will always be reflected on the insurance explanation of benefits.

What is a copay?

A Copay is an amount set forth by your health plan. Copays are due for each office visit at the time of service.

What is a deductible?

A deductible is set forth by your health plan. The deductible may apply to some or all services. For instance, laboratory services may have a $200 deductible. This means your insurance company will not pay anything towards laboratory charges until the $200 amount is met. Questions about your specific deductible should be directed to your insurance company.

What is coinsurance?

Coinsurance is a percentage that is your responsibility. For instance, some plans pay 80% of a charge and will always leave the patient with the other 20%. Please contact your health plan regarding your specific coinsurance requirements.

What is a "COB" issue?

Often times, an insurance company will update their records on an annual basis. This includes verifying that your child is covered under just one health plan. This information can be updated only by the parent, not us. If we submit a claim and it is denied for this reason, your statement will reflect that additional information is needed from you. You will then need to call the insurance company and answer their questions over the phone. You will also need to advise them to reprocess any claims they have denied for this reason. We will continue to bill you for these services until they are handled.

What if I believe my insurance should have paid the balance?

You should contact your insurance company in this case. It is best to know the exact date of service when calling them. If you are told the claim will be reprocessed, please ask how long it will take and then advise us of the information.

Are payment arrangements acceptable?

Yes. We can arrange a monthly payment plan with you. We require the monthly payment to be at least ten percent of the outstanding balance. We can arrange for you to send your payments upon receiving a statement each month. We can also arrange an "auto-pay" plan with you in which we process a credit/debit payment on the fifteenth of each month.

Can I make a credit card payment over the phone?

Yes. You can avoid sending your credit card information through the mail. We can take your information over the phone, process the payment, and mail a receipt to you.

Why does my statement reflect only "Balance Forward" or "Previous Balance" and no details?

Your statement will reflect only transactions posted within the month of your statement. An unpaid balance will then carry over to the next month; however, the detail will not print again.