Financial Policy

Our practice is committed to quality medical care. We are your child’s medical home! As part of that, certain financial responsibilities must be respected.

The parent /guardian who brings the patient in is the one responsible for all charges and payments. If the Insurance changes, please notify us right away.

INSURANCES

We have attempted to participate in all insurance plans. This is regardless of their reimbursement to our practice for services provided.  Your insurance plan contracts with us and requires us to abide by its rules for payment, and coverage (which services will be covered).  These may not always be the services or medications that a child needs. We will try to respect that arrangement but will never compromise your child’s health.

All payments for anticipated services must be made at the time of registration.

COPAYS

We are by contract obliged to collect this fee at the time of your visit and must be paid at the time of registration for each visit. Please have your co-payment ready at check-in. Usually Co-pays are waived for Well visits, However if an additional diagnosis is made during your Well Visit, the insurance will require the co-pay.  Co-pay with Health Assessments Statements we have at Front Desk for Patients.

DEDUCTIBLES

Each insurance plan has different benefits and deductibles.  We will always take that into consideration.  If at your visit, we cannot establish exactly what your obligation is, we are forced by circumstances beyond our control to assess a charge for payment. This must be paid at the time of the visit. Once your insurance informs us that the deductible has been met, your account will be adjusted. Sometimes, the insurance may also apply the charge to your deductible for a Schedule 2 prescription refill.

ADDITIONAL SERVICES at HEALTH ASSESSMENT

Often unknown to patients are the “insurance billing rules.”  For example, co-pays for health assessments (well child care) are most often waived; however, if a medically significant diagnosis is addressed, insurance rules require us to report that diagnosis. They usually then require a co-pay for that service. Also, if lab work is ordered, please be sure that the lab has your correct insurance information. Otherwise, they will bill you.

BILLING SERVICES

Our medical business system, like most today, is not designed to establish an account receivable billing service. We cannot extent a “bill me” amenity to patients. Thus, except for insurance-determined “patient responsibility,” we are unable to bill you for services provided.

Copays and outstanding balances must be paid at the time of registration of current office visit.


LATE FEES / COLLECTIONS

You should make full payment (or call to set up a payment plan) within a reasonable time period. If not, the balance may be sent to collections. We may also pursue legal action to obtain payment. If you’re having difficulty meeting medical bills, we would be happy to help you by setting up a payment plan. Otherwise dismissal from the practice may occur.

DISCOUNTS

Our office does not provide discounts for any services!

SPECIAL CIRCUMSTANCES

We are committed to providing excellent medical care to your children.  We understand that medical care can often be unexpected and expensive, and also that personal financial circumstances can change.  We do not wish that to affect your child’s health and care. Thus, our policy is to consider and possibly make exceptions for a short period of time. For this consideration, a parent/guardian must speak with a member of our business office before any services occur.

We are also happy to work with families to create a payment plan. Just ask us!

 

PATIENTS WITHOUT INSURANCE/SELF-PAY

If you do not have health insurance, payment must be made at the time of registration.

MISSED APPOINTMENTS

Life and traffic happens, so we understand that sometimes you cannot make your appointment. Please call us to cancel 24 hours in advance or to change an appointment. If you don’t call to cancel in advance, we reserve the right to charge a No-Show Fee (currently $50) to cover the cost of the missed physical/ well child visit and the same will be applied to any missed sick visits. Missed Consultation appointments will be charged $125. So please call our office to reschedule or cancel as need be. Multiple missed appointments, or failure to comply with other Burke Pediatrics policies, may result in dismissal from the practice.

RETURNED CHECKS

If you pay by check and your check is returned for insufficient funds, you will be responsible for the amount of the check, and a returned check fee ($35 or more). If this occurs multiple times, we may require all future payment in cash or by credit card.

FORMS

Health insurance programs do not cover the cost of researching, filling out and signing forms. We charge a small fee to cover these costs of completing forms. The fee will charged at the time of check-in and may change from time-to-time. Please allow three business days for completion of the form.

MEDICATION REFILLS

Only certain medications can be safely refilled without a patient visit and reevaluation. During office hours, the physicians are concentrating on the patients in the office and therefore, will often deal with refills once all patients are gone. Because of this plus the additional research into the chart and pharmacy notification, a fee will be assessed.

MEDICAL RECORDS

Your child’s medical records are now available on-line via our PATIENT PORTAL. If you desire the entire record or a printed copy, you must make a written request. Please allow five business days. A minimum charge must be paid at the time of picking up the record.

SPORTS PHYSICALS

Virginia Department of Education requires that this physical occur on/after May 1 of current school year for the following sport seasons. We recommend yearly physicals for all children and teens. For athletes, please schedule this health assessment after May 1 for the following school year. Insurance may not cover this but we are happy to do them with your annual visit if it satisfies the State, School and Insurance requirements. If not covered, the physical and form can be done for a fee of $90.

SATURDAY VISITS

These appointments are to help prevent a visit    (and wait) to the emergency room or urgent care. Always call first for an appointment.  Since the office does not have regularly scheduled hours on weekends, an additional fee will be charged at the time of the visit. Insurance does not cover this charge.  Our after hours answering service is staffed by pediatric nurses and provides phone coverage when we are not open.

AFTER HOURS TELEPHONE SERVICE

Whenever our office is not open, you may contact our professional medical answering triage service.  If it is not a true medical emergency, a fee will be assessed.

A practice physician is always on call 24 hours everyday all year long.

FLUORIDE APPLICATION

This usually occurs at your child’s well visits from the time they have teeth through the age of 2. Some health insurance programs cover this service. If not covered, the application can be done for $25.

VACCINES

These are covered by health insurance. If you do not have any coverage, the vaccines will be provided free through the Virginia Vaccine for Children (VFC) program, but an administration charge will be assessed for each vaccine.


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Financial Policy