It is the policy of ABC Pediatrics to require all current insurance information on every patient at the time of scheduling the appointment. No appointment will be made without this information. ABC Pediatrics will verify coverage and confirm that ABC Pediatrics is the primary care physician of record. The responsible party must inform ABC Pediatrics of any changes in coverage for existing patients prior to scheduling an appointment. All current patient balances are to be paid prior to scheduling an appointment.
Per contracts with insurance payers, ABC Pediatrics is to collect appropriate copays from every patient/parent/responsible party at check in, prior to services being rendered. Responsible party will be required to show proof of current insurance (insurance card) for each patient at each visit.
It is the policy of ABC Pediatrics to collect the patient portion of coinsurances, deductibles, non covered procedures and tests at check out based on insurance company allowables. Any non- Medicaid patient qualifying for "Vaccines for Children" must pay for immunizations given on the day of service at check out. Uninsured patients (self pay) must pay for all services on that day of service at check out.
Well Child Exams and Sick Visits
In the event that your child comes in for a well child exam but other clinical issues are addressed in the same visit, the combined visit may generate a co-payment, per your insurance contract, for the sick portion of the visit. This co-payment will be due at the time of check out. In the event the other clinical issue requires a substantial amount of provider time to address, your well child exam may need to be postponed to another day. The separation of the visit will allow our providers to provide a thorough assessment of the new clinical issue.
Delinquent status: Collection Agency
It is the policy of ABC Pediatrics to send patient statements electronically, via the patient portal, in an effort to reduce healthcare costs. If a patient balance (due from patient) is incurred, responsible parties are encouraged to mail the payment directly to ABC Pediatrics upon receiving the EOB (explanation of benefits) from their insurance company. It is the policy of ABC Pediatrics to electronically send at least three statements in an effort to collect the balance due. If no payment is received 90 days after the date of service, the account will be reviewed and turned over to the collection agency. All accounts turned over to the collection agency will also be responsible for the collection agency fees. Currently the collection agency placement fee is 30% of the outstanding balance
No appointments will be made for any children of the responsible party while the account is in collections with the collection agency.
Coordination of Benefits
Coordination of benefits: Responsible parties must respond to the request for information from the insurance within 10 business days. A failure to respond to a request for COB information from the insurance will result in all charges becoming patient responsibility.
Returned Checks: Any checks returned to ABC Pediatrics for insufficient funds (NSF) will incur a $35.00 charge. It is the responsibility of the check signer to pay, by cash or credit card, both the check amount and the $35.00 charge immediately. A failure to respond to ABC Pediatrics within 15 business days will result in the NSF check and charge being turned over to the collection agency. Check signer will also be responsible for all collection agency fees.
Due to the frequency of patients failing to show up for scheduled appointments, it is the policy of ABC Pediatrics to assess a No-Show fee anytime the patient/responsible party fails to notify ABC Pediatrics in advance of a cancellation or change in a scheduled appointment.
The No-Show fee is $50.00 for failure to cancel or change a Well Child Visit (Physical) 24 hours in advance of the cancellation or change in this type of appointment. The No-Show fee is $30.00 any time a patient/responsible party fails to notify ABC Pediatrics 1 hour prior to a sick or recheck appointment. This allows the scheduling department to try to give the appointment to another patient. To cancel an appointment before or after office hours and on weekends, please call the answering service at 404-935-6730.
It is the policy of ABC Pediatrics to send patient statements electronically via the patient portal in an effort to reduce healthcare costs. The telephone number on file will receive a text message when the statement is available to review. When a no show fee is incurred, responsible parties are encouraged to mail the payment directly to ABC Pediatrics. If 30 days after the generation of the first statement it is necessary for ABC Pediatrics to mail a second statement because no payment has been received. If no payment is received 90 days after the date of service, the account will be reviewed and turned over to the collection agency.
All accounts turned over to the collection agency will also be responsible for the collection agency fees.Currently, the collection agency fees are 30% of the outstanding account balance
Billing for Treatment of Automobile Accident
It is the policy of ABC Pediatrics, that when one of our patients is injured in an automobile accident we understand the automobile insurance (bodily injury that is mandatory for every driver in the State of Georgia) shall be the primary insurance covering the treatment of the injuries.
The health insurance policy, including Medicaid, shall be secondary.
It becomes the responsibility of the automobile insurance company to coordinate benefits.
It is the policy of ABC Pediatrics not to bill automobile insurance companies for medical services.
The patient/parent will be responsible to pay for an office visit charge of not less than $145.00 at check-in, before services are rendered. Then the balance of the charges for the actual additional services rendered shall be due and payable at check-out before the responsible party leaves the practice.
The prompt pay discount does not apply.
The responsible party will receive an itemized super bill as a receipt for the services rendered with the amount paid and the form of payment included, so they can easily submit the receipt to the automobile insurance company.