follow us on twitter find us on facebook

 

 

 

 

 

 

 

 

 

 

Gloucester County Pediatrics Accepts the Following Insurances:


Please contact our office regarding additional plans not listed.


At no time should the health of your child be comprised by financial problems. Therefore, please discuss such difficulties with us and appropriate arrangements such as payment plans can be made.


Insurance guidelines:


Please use your child’s legal name for all insurance and medical records and designate one of the doctors at Gloucester County Pediatrics as your primary care physician.


In order to bill your insurance company for services provided, it is critical that we have current insurance information in our records. We will ask for current insurance card at each visit to ensure that our information is correct.


If you have a deductible or health saving account plan, there may be a patient balance after the insurance company has paid their portion of the bill. We will bill you for this balance due.


It is the Responsible Party’s responsibility to be aware of the patient’s insurance benefits. Not all services provided by our office are covered by all plans. Please feel welcome to ask us if you have any questions about your plan- we may be able to help you.


If you have two insurances we will bill the primary insurance and the secondary insurance.


Your insurance company may request additional information from you before they process claims. Please respond promptly to any requests from your insurance company. Failure to respond to insurance company requests may result in unpaid or denied claims in which case the patient becomes fully responsible for these charges.

 

REFERRALS & PRECERTIFICATIONS

Many managed care insurance plans require "referrals" for the patient to be evaluated by a specialist. Many managed care referrals are now generated electronically. Hard copy referrals are not issued on short notice, and may require 24 to 48 hours to process correctly. In similar fashion, many health insurance plans also require "precertification" before certain testing can be performed. This is a review process that often takes 24 to 48 hours as well. Please call our office 48 hrs. prior to your appointment with the specialist so that we have the time needed to prepare the referral.

MEDICAL SERVICE PAYMENT POLICY


INSURANCE:

We participate in most insurance plans excluding Medicaid/Medicare. If you are insured by a plan with which we do not participate, payment in full is expected at each visit. If you are insured by a plan with which we do participate, but the policy is not current and up-to-date, payment in full for each visit is required until we can verify your coverage or within 14 days of the billing statement. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

CO-PAYMENTS AND DEDUCTIBLES:

All co-payments and deductibles must be paid at the time of service. If you do not have your co-payment at the time of service, you will be charged a billing fee of $10.



PROOF OF INSURANCE:

All patients must complete our patient information form before seeing the doctor or nurse practitioner. We must have a copy of your current valid insurance card or ID to have proof of insurance. Failure to provide us with the correct insurance information in a timely fashion may result in your being responsible for the balance of the claim.



CLAIM SUBMISSION:

We will submit your claims. Your insurance company may need certain information directly from you. 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. Your insurance benefit is a contract between you and your insurance company.



COVERAGE CHANGES:

If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 60 days, the balance will be automatically billed to you.



NON-PAYMENT:

If your account is over 60 days past due, you will receive a letter stating that you have 30 days to pay your account in full. Partial payments will not be accepted. Please be aware that if a balance remains unpaid, we may refer to your account to a National Collection Agency authorized to report all outstanding debts to the four major National Credit Agencies.



ADDITIONAL COST OF COLLECTION SERVICES:

In the event of non-payment, Gloucester County Pediatrics will charge a late fee of 1.5 percent per month for outstanding amounts over 60 days from the calculated due date, in addition to the original invoice total. Please be aware that there is a service fee of $30 for returned checks. If the balance remains unpaid, routine checkup and vaccination appointments will not be scheduled until the balance is paid.



MISSED APPOINTMENTS:

Our policy is to charge $25 for missed appointments not canceled 24 hours in advance. Please help us to serve you better by keeping your regularly scheduled appointment.