How Billing at Med-Peds Mgt works

We can help:

We are happy to help you by billing your insurance company.  If we bill your insurance for you, you will pay co-payments and any unmet deductibles at the office that day.  We accept check and credit card payments.  We do not allow patients to carry a balance with us unless you have pre-arranged this with Jewel, she has payment plans that you may participate in. 
If you need help let us know; however, you are responsible for all services that you receive at Highlands Pediatrics or Internal Medicine Associates.  It is extremely important that you know what your insurance covers and what it does not.  We are not able to advise you on coverage for most commercial insurance since the plans are so varied and may different from patient to patient even within a particular plan.  We provide a phone at the front desk to allow you to call your insurance company to check on your coverage if you are unsure at the time of your visit.  Unfortunately, some insurance companies will not pay for services despite the fact that you need them, you should be particularly careful with preventative and screening services such as vaccines and physicals.  If your insurance company does not cover a service or only partially pays for this service, you are responsible for the remaining reasonable and customary fee.  We typically give a 33% for services if you have to pay out of pocket.  Medicare coverage guidelines are included at this website www.cms.hhs.gov
If you would prefer to bill your insurance company yourself we will collect the fee when you come to the office and we will provide a receipt. 

Billing Insurance Companies:

When we bill your primary insurance, the service is described as “insurance pending”.  When we hear from your insurance company via an explanation of benefits or eob (which you will also receive a copy of directly from your insurance company), we update your account to reflect payments, denials and other information.  Usually there is some payment due from you after your insurance company has paid their portion; you pay this amount at your next visit or with your next statement, which ever is sooner.  This balance is due immediately.  Please do not ask us to bill you this amount when you come to the office.  If you have secondary insurance, we will bill them once we have heard from your primary insurer.  We will bill each insurer twice, if we do not hear from them, the balance will be turned over to you.  At that time, if you believe your insurance coming has not paid what they owe, it is essential that you call your insurance company to find out why they are not honoring your contract, this is not something we can do for you.  Many patients make the mistake of waiting too long once a balance has been turned over to them and their insurance companies then simply refuse to pay it as being “untimely” - the insurance company version of “you snooze you lose”.  If your current insurance information has changed it is important that you let us know immediately so that new services can be billed to the correct insurance company within the 90 days that most commercial insurance companies allow. 
We participate in the Equifax