Billing Policies Billing Policies

Thank you for choosing The Children's Health Center for your child's medical care. We are providing you with the following information to help you understand our insurance and billing policies. If you have any questions, please contact our Billing Department at 201-868-4538.

Your Responsibilities:

  • You must show your current insurance card at every visit. This is to protect you from recieving a bill because we did not have the correct information. We will attempt to validate your insurance at the time of service and alert you to any problems. If we cannot validate your coverage, we may assign your account to self-paid status and request full payment at the end of your visit.
  • You must pay your copay at the time of the office visit. Our contracts with insurance companies require us to collect your co-pay at the time of service. We accept cash, checks and credit cards. There will be a $25. returned check fee, and you will be place on a "cash only" basis.
  • If your insurance plan is subject to routine deductibles and co-insurance, we require you to keep a credit card on file so we can collect those charges as soon as your insurance carrier assigns the appropriate amount of responsibility.
  • Know your insurance benefits. Your insurance policy is a contract between you and your insurance company, even if your employer provides it. There are many subtle diffrences in insurance policies, and employers frequently change coverage and co-payments. You are responsible for knowing what services are covered, and how much of the cost is your responsibility. You will be reponsible for any portion of services your insurance does not cover, or for which you have a deductible that has not yet been met. You should also be aware of which lab or radiology department is covered by your insurance company.
  • If your insurance requires you to choose a primary care physician, you must call your insurance and select our office as soon as your medical records are transferred.
  • If you have a newborn or newly adopted child, congratulations! Your child is covered for the first 30 days by the mother's policy, regardless of which parent will provide ongoing insurance coverage. You should contact your carrier as soon as feasible to add the new child to your policy. Permanent coverage must be in place before the automatic newborn coverage expires.
  • If your child is covered by more than one policy, be sure to know which one is considered primary. We must submit claims to the appropriate carrier(s) in the right order.
  • Carefully read all Explanation of Benefits statements you recieve from your insurance carrier. We receive the same statements, and any charges which your carrier disgnates as "patient responsibility" will be billed to you directly to you from our office.

 

Our Collection Procedures:

  • If your account is self-paid, all services must be paid for at the time of visit. This may include situations where we cannot validate your insurance. In such cases we will collect payments at the time of service and refund any amounts subsequently collected from your carrier.
  • If you have valid coverage with a participating insurance carrier, we will file an insurance claim within five business days of your date of service. If there are any problems with the claim we will notify you immediately and request your assitance. If your carrier does not respond in 30 days, we will send out a second claim. If they don't respond in 60 days we will send you the statement, and payment will become your responsibility. You will need to contact your carrier if you think they are responsible for payment. We will expect payment from you or them in 30 days.
  • If your participating insurance is subject to routine deductibles and/ co-insurance that cannot be collected on the date of service, we will charge your credit card on file as soon as your carrier provides an EOB designating your financial responsibility.
  • If you are insured by a non-participating insurance carrier, we will expect payment at the time of service, and it will be your responsibility to submit any claims to your carrier for direct reimbursement to you.
  • All statements are due on receipt. If charges remain unpaid for 30 days a second statement will be mailed. There will be a $5 monthly late fee charged for any unpaid balances.
  • We reserve the right to place your account with our collection agency after all internal efforts to obtain payment have been exhausted. You are then responsible for any collection costs in addition to you out standing bill. If you are presently in collections, the practice will use its discretion as to providing you with further treatment or asking you to find another doctor.
  • Please be advised there is a $1 per page medical record copy fee if needed.
  • There is a $50 charge for Medical Leave paperwork for Parents/ Guardians.
  • If you have an appointment you need to cancel please call at least 24 hrs prior. There will be a $25 No Show Fee if you do not call to cancel an appointment.
  • As a courtesy we do not charge for school/camp forms or medical waste disposal like most offices do.
  • For your convenience you can also make Credit Card payments on our website or over the phone.
  • In the event that your account needs to be placed with an attorney or a collection agency because of an unpaid balance remaining the account , patientas agree and promise  to pay interest of 1.5% per month of the outstanding balance (to be calculated starting from last date of service).  In addition, also agree and promise to pay a collection fee of $100.00 or 40% of the total balance due, whichever is greater, upon placement with an attorney or collection agency due to an unpaid balance remaining on the account.