Thank you for your business. We do expect payment within 30 days, so please process our invoice within that time. We encourage patients to leave a credit card on file as a feature we offer for convenience.
In order to keep our charges as reasonable as possible, we ask that you pay all co-payments and balances on the day of your child’s appointment. Payment plans can be discussed on an individual case by case basis.
We do expect payment within 30 days, so please process our invoice within that time.
Invoices not paid in full within 120 days will be referred to a collection agency and may result in your child’s dismissal from our practice.
Please have your child’s current insurance card available to us at each office visit. We must have the correct insurance information so that we can submit claims to your insurance company for timely and proper payment of services we have rendered. If you do not have a valid insurance which we can verify electronically, you will be considered a “self-pay” patient. This means you will have to pay for the visit in its entirety the day of service. We will give you a receipt as record of payment for you to submit to your insurance company for reimbursement. If your insurance company has not paid a claim after 60 days from the date of the visit, the bill becomes your responsibility. If your coverage was terminated and you do not present us with the new insurance card within 30 days of the date of service, the bill is your responsibility.
East Bay Pediatrics has enrolled in numerous managed-care insurance programs to accommodate our patients. Each plan has different requirements placed on you, the subscriber, to determine if the insurer will pay for your medical expenses. Even within the same insurance company, the plans differ in the type of contract you or your employee has negotiated. Therefore, it is your responsibility to know and understand the specific details of your insurance plan to avoid potentially needless out-of-pocket expenses. While we may assist you with pharmacies, referrals, and laboratories, it is not possible for us to be familiar with the specific coverage of your particular insurance plan. Some insurance plans limit procedures and services in order to control costs. It is our responsibility to provide your child with what we consider to be the best medical care according to current practice guidelines. Certain services we provide may not be reimbursed by your insurance company and will therefore become your financial responsibility. These services may include:
- Lab/imaging studies: Your insurance carrier may require you to use a specific lab or other outside facility. Failure to do so may result in charges to you which your insurance company does not cover.
- Referrals: Most managed care plans require that we receive authorization for referrals to a plan’s list of specialists. If a specialist is not on your ‘list’ or if authorization is not received in advance, you will be required to pay out-of-pocket for the appointment.
- Other services: Fluoride applications, cholesterol testing, hearing tests, extended telephone conversations and written correspondences. If these services are not covered by your insurance carrier, you will be billed for these services directly.
Please make every effort to become familiar with the benefits of your plan. If you have any questions regarding your coverage, please contact your insurance company directly.
If we participate with a company that insures you, we will submit the bill for you. You are, however, responsible for any deductibles and balance your plan indicates on their EOB (explanation of benefits). We send a monthly statement to the individual listed as the ‘subscriber or responsible party’ on the Demographic Form for any outstanding balance and for charges stemming from services not covered by your insurance company. These balances are due in full within 30 days of your first billing.
Blue Cross Products
Health Care Value Management
RITE Care Products
United Health Care Plans