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Financial Policies

Co-pay/Deductible/Coinsurance

We are required by our insurance contracts to collect all copays and other patient responsible amounts, at the time of service. Your insurance is a contract between you, your employer, and the insurance company. We are not a party to that contract. We cannot be responsible for keeping up with the ever-changing policies of each individual insurance plan. Depending on your individual plan, all services may not be covered. Know your benefits and be prepared to make the copay, deductible, or co insurance payment at the beginning of the visit. We accept cash, check, and all major credit cards. Please note, if we do not receive your payment at the time of service, we will charge your account a $10 ‘No Co-payment processing fee.’  

 

No Insurance 

If you have no insurance, we collect $100 for your initial visit and $75 on your follow up visit. (Note: There my be additional charges to your office visit if scopes or procedures are required.)   

 

Payment

We accept cash, Visa, MasterCard, and American Express. We also accept payment by check and debit cards.     

 

Returned Check

Our return check fee is $25. After two returned checks patients are required to pay with cash or credit card only.   

 

Outstanding Balances

We have the right to dismiss a patient from our practice if they fail to provide payments under the agreement terms. Failure to pay account balance within 30 days from initial billing may result in interest charges up to maximum legal amount allowed by law. Any past due balance not paid will be turned over to a collection agency after 90 days.   

 

Insurance 

We participate in most insurance company plans. Advanced Kids Care is not responsible for knowing your insurance policy coverage. You must contact your insurance company to determine what your policy will cover.  Our billing staff will file all claims for covered services with your insurance company if we are a contracted provider.  You are responsible for any balances that may be due to the provider as a result of: Co-insurance, deductible, non-covered services, out of network services, terminated coverage, exhausted benefits, no insurance coverage, failure to respond to insurance company correspondence, failure to list our provider as your primary care provider, and failure to notify in advance that Advanced Kids Care lab facility is not a preferred provider. Additionally you must notify us of any changes in insurance before services are provided. We will NOT be responsible for any denied claims due to filing deadlines if new insurance information was not given at the time of service.       

 

Claims submission

We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

Billing Statements 

Billing statements are sent out at the beginning of each month. Any balance not covered by your insurance must be paid in full BEFORE your next appointment. Failure to pay account balance within 30 days from initial billing may result in interest charges up to maximum legal amount allowed by law. Any past due balance not paid will be turned over to a collection agency after 90 days.   

 

Payment Arrangements 

Payment is expected at the time of service. Unless other arrangements have been made in advance. Payment arrangements can be made with our Insurance Department. These arrangements must be done in only 2 payments and 30 days apart. As a condition for a payment arrangement you must leave a credit card authorization on file with our insurance specialist.   

 

Medicaid 

We file Medicaid patients claims for the state of Texas. We verify eligibility at the time of service. If patient is not active on Medicaid patient will be treated as ”No Insurance” patients. See No Insurance policy above.   

 

Newborn New Patients 

It is your responsibility to insure that your newborn is promptly added to your medical insurance. If your newborn does not have medical insurance by their next visit, you will be responsible for the balance in full on the date of service and all other services following until medical insurance coverage is provided to Advanced Kids Care.   

 

You are responsible for providing us with the correct insurance card for the newborn.  It is your responsibility to contact your insurance company within 30 days of birth to add your newborn dependent.   

 

Involvement of Providers in Finances

So that our providers are solely concentrated on your child’s as well as other children’s medical needs, they do not get involved in financial issues with your account. We have a dedicated Insurance Department that will gladly assist you with these issues. Rest assure that our office will do its best to accommodate your financial needs. 

 

Credit Card Authorization on File

Due to changes in healthcare insurance, especially new high deductible plans, we require a valid credit/debit card be kept on file for all its patients. Your credit card on file will be utilized to settle any deductible or additional balances that were not paid at the time of service. 

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