Billing & Payment Policy | callie-pediatrics

Billing and Payment Policy

CALLIE PEDIATRICS, PC

(Effective May 1, 2020)

Insurance: We participate with many insurance plans. However, insurance plans change, so we ask you to know your benefits (copays, deductible, network, covered services, etc.) and to bring your insurance card to each visit. If your insurance changes please notify us before your next visit. If there is a lapse in insurance coverage, you will be expected to pay in full at the time of service for all appointments until insurance coverage is reinstated.

Copayments/Deductibles: It is your obligation to pay your co-payments, estimated deductibles and coinsurance, and non-covered services at the time of service. Whoever brings the patient (mom, dad, grandparent, aunt, etc.) into the office is expected to pay at check-in. Please contact your insurance company to determine deductible and other amounts prior to your appointment.

Claims Submission: We will submit your claims and assist in any way we can to get them paid. Your insurance company may need additional information from you directly. Please provide this information promptly. Please be aware, any unpaid balance (copays, deductibles, coinsurance, and non-covered services) is your responsibility.

Divorce/Shared Custody: Child custody arrangements have no impact on insurance. Whoever brings the child into the office is expected to pay the charges due for the service rendered that day. Callie Pediatrics, PC does not participate in payment disputes between parents.

Appointments: Unless it is a medical emergency, before scheduling an appointment for your child, you will need to pay off any outstanding guarantor balance or enroll in a payment plan.

Billing Statement Procedure: If you have a balance, you will receive up to two consecutive statements from our office. Once a second statement is required, the account will be considered delinquent. We do, however, offer a limited payment plan for those patients who are experiencing serious financial strain. You must contact us promptly at the date of service or upon receipt of the first statement. If we haven’t received full payment on your account after two statements have been sent, the account may be sent to an outside collection agency. Additionally, you (and any siblings associated with the responsible party) may be dismissed from the practice at which time you will be given a 30-day notice to select a new primary care physician. During that 30-day period we will continue to provide only acute medical care for your child and full payment for services rendered will be due upfront. We appreciate your prompt payment on outstanding balances.

Late Payment/ Interest /Collections Whether a patient or agent, you understand and agree that if payment is not received in the office (or through online "Quick Pay") within thirty days of initial billing, it may be charged 18% per annum interest on the past due balance. In the event that it becomes necessary to collect the balance due, an additional 35% of the principal balance due will be added to help defray the cost of collection. In addition, should legal action become necessary to collect the balance due, you understand (as a patient or agent) that you will be responsible for reasonable attorney’s fees, interest, and court costs. Should the account be placed with a collection agency or attorney you understand that a credit report may be pulled for the sole purpose of collecting the delinquent balance.

Sick Care during a Well Exam: If in the course of a patient’s well exam a separate, non-well issue presents which needs to be addressed, it may be addressed during the current visit or at a subsequent visit. If addressed at the time of the current well exam, an additional E&M code (evaluation and management) will be added to the visit. Your insurance company may require second co-pay or a deductible may apply for the additional service or procedure. Callie Pediatrics, PC will file your claim. If the EOB (explanation of benefits) shows an additional amount is owed by the patient, you will receive a bill for that amount.