Pediatric of Northeastern PA - Specializing in the heath care of children from birth to 18.

Financial Policy 2008

Pediatrics of Northeastern Pennsylvania participates in most health care insurances. However, there are some guidelines we ask our patients to know and understand.

Our office policy is that our patients present their insurance card at every visit to guarantee that our office staff has the correct information at all times. With this information we can bill your insurance company for your visit and our nursing and referral staff will have the information they need to complete referrals, prescriptions and any other issues for our patients.

Payment for all services is ultimately the responsibility of the parent or guardian who presents to the office with the patient. Pediatrics will submit a claim to the patient’s insurance carrier providing Pediatrics of Northeastern Pennsylvania is a participating provider. If this claim is not paid within a timely manner (60 days) by the insurance company, then it becomes the responsibility of the parent or guardian. If the health insurance coverage is with a company for which Pediatrics does NOT participate in, the parent or guardian is responsible for payment at the time of service unless prior arrangements have been made with Pediatrics’ billing department. At check out, the parent or guardian will receive a form to submit to their insurance company to receive reimbursement for these services, if possible.

The parent or guardian is responsible for all co-payments and non-covered services at the time of service. Any co-payments not paid the day services are rendered will be subject to an additional $10 fee. Deductibles or rejected claims should be paid to Pediatrics within 30 days of receipt of a bill from Pediatrics of Northeastern Pennsylvania.

For your convenience we accept Cash, Check, MasterCard, Visa or Discover. (Any checks returned unpaid by your financial institution will be subject to a fee of $25)

(Any appointments not cancelled prior to the appointment will be subjected to a $35.00 No Show Fee.)

Insurance contracts are between the subscriber and their insurance company. To use insurance benefits to cover any ordered tests, procedures or visits to specialists it is the responsibility of the parent or guardian to contact the subscriber’s insurance company to verify benefits and participating facilities and specialists. The parent or guardian is responsible for requesting any necessary referrals prior to seeing any specialists, and prior to having any tests or procedures performed. When possible these requests should be made 5 days prior to the appointment date with the specialist. It is up to the discretion of a Provider whether or not to issue a referral requested after the appointment or procedure date. Any denial of payment for ordered tests from an insurance company is between the subscriber and their insurance company, realizing referrals are not a guarantee of insurance benefits or payment.

Please remember that we are here to serve our patients to the best of our ability, we request the help and cooperation of our patients.