Financial Policies

Pediatric Care, Inc. participates with most major insurance companies and will file all charges incurred with the appropriate claims office. In order to file promptly and accurately, an insurance card must be provided at each visit.

Today’s health insurance policies and coverage offer more options than ever. Each patient is responsible for knowing his or her plan’s benefits package, co-payment, co-insurance, deductible, non-covered services, and restrictions.

We will not bill another insurance carrier supplied at a later date, if it is past the timely filing period for that insurance company. If a child is insured by more than one insurance company, our office needs to have all insurance companies’ names on file.

All co-payments, co-insurance, and deductibles are due and payable at the time of service per your contractual obligation with your insurance company.

Co-payments

Pediatric Care, Inc. is contractually obligated to collect your co-payment at the time of each visit. The cost of billing co-payments often exceeds the actual co-payment amount, therefore, our policy will be to charge a $10.00 processing fee if you are unable to pay your co-payment at the time of service.

Co-insurance/Deductibles

Pediatric Care will collect $50 per visit until your deductible has been met and co-insurance amounts have been established. Once the co-insurance amount has been established, the amount due at each visit will be the co-insurance percentage of the charges incurred, plus any deductible not yet met for the year.

Full payment will be due at the time of service. If you are unable to pay your balance in full, you will need to make prior arrangements with our billing department. Please note that equal access is provided to all patients regardless of source of payment.

We encourage patients without insurance to visit the appropriate sites to review options: 

• State of Ohio
• HealthCare.gov

Full payment is due at the time of service. Due to the lengthy settlement process, our office does not get involved in third-party liability claims.

We ultimately hold both parents responsible for payment. In circumstances where the parents are separated or divorced, Pediatric Care will not act as a mediator in collecting our payments. If the account is not resolved in a timely manner, both parent’s information will be submitted to our collection agency. Please see our Policy for Divorced and Separated Parents.

A $30.00 charge will be added to your account for any check returned by your bank for any reason.

Billing statements are mailed monthly. All patient balances are due in full upon receipt. Accounts with unpaid balances over 60 days may be assessed a $5.00 monthly statement fee.

All insured and non-insured patients may be charged a $50 “no-show” fee on the second and third missed appointments and dismissal from the practice may result after a subsequent no-show.

When possible, we require cancellations to be made at least 24 hours prior to your scheduled appointment. All cancellations made with less than a 24 hours’ notice may be subject to a cancellation fee.

No-shows and cancellations are traced by family, not per patient.

If there are excessive no-shows, they will be handled in the following manner:

• 1st No-Show: The patient will receive a letter informing them they missed their appointment and that another missed appointment, without notifying the practice within 24 hours, may result in a $50 fee.
• 2nd No-Show: The patient will receive a letter informing them that they have now missed two appointments without notifying the office and they may be charged a $50 fee.
• 3rd No-Show: The patient will receive a letter informing them that their account has been flagged as habitual no shows and that another no show may result in dismissal from the practice. They may be charged a $50 fee.

Patients who no-show two or more children at the same time, will be restricted from scheduling double appointments in the future. Missed Appointment Fee Policy

If insurance coverage cannot be verified, you will be expected to pay in full at the time of service. If you are unable to pay the charges in full, you may be asked to re-schedule your appointment or make payment arrangements with our billing department prior to your visit.

We ultimately hold both parents responsible and will try to resolve the balance in a timely manner. If we are unable to resolve the account, it will be sent to collection with both parent’s information. Please see our Policy for Divorced and Separated Parents.