It is my goal to offer the very best in pediatric care at a fair fee. I welcome any questions you might have about our fees or any specific charges. For office visits, payment is expected at the time of service. If there are family or individual deductibles or copays, they must be paid in cash at the time of service. They will not be billed for payment at a later time or billed to a second insurance company.
For hospital services the office will bill your insurance company directly, but will still hold you ultimately responsible for payment. If there are family or individual deductibles or copays, they must be paid for in full in cash as well. Services must be completely paid for within sixty (60) days of providing the service.
For private insurance carriers:
- Please bring your insurance card(s), an updated insurance form with the correct social security number, group ID number, employer information, and guarantor’s signature. It will be necessary for you to bring in your private insurance form only one time ( unless you change to a new insurance company or policy), since our office is fully computerized to process all billing information.
- It is the guarantor’s responsibility to provide accurate insurance cards, signed forms, and appropriate billing addresses for insurance at the time of service. If this information is not available at the time of service, then the guarantor will make full payment in cash for the service provided on the date of service without exception.
- Copayments for office visits are due and payable in full at the time of service. Copayments will not be billed for at a later date nor will the copayment or deductible be billed to a second insurance company.
- It is the guarantor’s/parent’s/guardian’s responsibility to make sure that this office has been selected as the child’s primary care provider.
- Authorization for services must be present at the time of the service or the service will not be performed.
For Medi-Cal carriers:
- Please bring in a card for the month of delivery and a current Medi-Cal card for the office visit (if different from the month of delivery). Please note that newborns are covered under the mother’s card only during the month of delivery and the following month. For example, if your baby arrives in October, he or she can be covered under the mother’s Medi-Cal card for the months of October and November only.
- It is the parents/guardian’s responsibility to make sure that the child has been placed with this office as his/her primary care provider with either of the managed-care groups.
Effective January 1, 1995, a modest fee will be assessed for all administrative costs of processing documentation such as (but not limited to) school physical reports, injury reports, and immunization (injection) records. In addition, fees for copying and transferring of medical records will be assessed and must be paid in cash prior to transfer of records.
A fee of $25.00 will be charged for a missed physical examination when the office has not been contacted at least 24 hours prior to the physical examination. The fee must be paid in full at the time of the next scheduled visit.