Financial Policy

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.

Delinquent status; Collection Agency:

It is the policy of ABC Pediatrics to mail as few patient statements as possible, 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 mail one statement in an effort to collect the patient due. 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, an interest charge of a flat 12% of the balance, but not less than $5, will be added to the account. If no payment is received 10 business days after the mail date of the second statement, 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.

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: 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 $25 charge. It is the responsibility of the check signer to pay, by cash or credit card, both the check amount and the $25 charge immediately. A failure to respond to ABC Pediatrics within 10 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.

 No-Show Policy

It is the policy of ABC Pediatrics to assess a $25 no show fee any time a patient/responsible party fails to notify ABC Pediatrics 24 hours in advance of a cancellation or change to a well (physical) appointment. It is the policy of ABC Pediatrics to assess a $25 no show fee 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.

It is the policy of ABC Pediatrics to mail as few patient statements as possible, in an effort to reduce healthcare costs. When a no show fee is incurred, responsible parties are encouraged to mail the payment directly to ABC Pediatrics. It is the policy of ABC Pediatrics to mail one statement in an effort to collect the no show fee. 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, an interest charge of a flat 12% of the balance, but not less than $5, will be added to the account. If no payment is received 10 business days after the mail date of the second statement, 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.

No appointments will be made for any children of the responsible party while the account is in collections with the collection agency.

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 $85.00 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.

This policy shall take effect on August 18th, 2006