Financial Policy

Thank you for choosing Pediatric Associates at Northwoods as your child’s medical home.

Our goal is to provide great quality care, with open communication and clarity about financial responsibility.

Health Insurance: Please keep in mind that it is your responsibility to know the details of your health coverage. With the many health plans that we accept, it is not possible to know each family's policy details. Important things for you to know include the following:

• Copayments for office visits
• Deductibles
• Coinsurance amounts
• Coverage limits (especially as they apply to preventive care visits)
• Vaccine coverage
• In-network providers for lab and radiology services

Also, from time to time, we may recommend treatments or testing that are not covered by your insurance. We make medical decisions based on what we believe is best for your child, not based on what is covered by your insurance company. Please understand that we are trying to provide the best care for your child. We ask that you:

• Present your insurance(s) card at every visit
• Inform us as soon as possible if your insurance carrier changes and provide us with a copy of your new card
  
  

Co-payments and deductibles: All co-payments and deductibles must be paid at the time of service. They are contractually set by your insurance company based on the policy you and your family have chosen, and we are contractually bound to collect them. The person bringing the patient to the office for their appointment is responsible for paying the copayment, deductible, and any outstanding balances on the account at the time of service unless previous arrangements have been made.

Services Not Covered by Insurance: It is your responsibility to check with your insurance company to determine covered benefits. The patient/guarantor is responsible for 100% of charges their insurance policy does not cover, including but not limited to co-payments, deductibles, developmental screenings, and after-hour/weekend appointment charges.

Well Child visit services: Well Child checks are preventive care services meant to evaluate your child’s growth, development, discuss preventative care, and review and administer vaccinations. If you have additional concerns that you would like to address such as fever, asthma, ear infections, initiating/changing a medication, ADHD etc., or if your child is medically complex, your insurance company may bill you a co-pay or apply this portion of your visit to your deductible. 

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.

Responsibility for Payment related to Motor Vehicle (MVA) or Worker’s Compensation (WC): Pediatric Associates at Northwoods will not bill any visit, related to a motor vehicle accident or worker’s compensation injury, to your medical health insurance. It is your responsibility to provide our office with the MVA/WC information, including but not limited to Carrier, address, date of loss and claim loss number. If you fail to provide this information, you will be responsible for payment for all services provided.

Returned Checks:  Pediatric Associates at Northwoods accepts personal checks as a form of payment. Checks that are returned from a bank for non- payment of any reason will incur a fee of $20.00 plus the amount of the check.

Please contact our billing department if you have any questions about your statement or your account.

THANK YOU FOR YOUR UNDERSTANDING AND SUPPORT!