PAYMENT POLICY

Thank you for choosing Apple-a-Day Pediatrics as your healthcare provider. We are committed to your treatment being successful. Please understand that payment for your services is considered part of your treatment. Your clear understanding of our financial policy is important to our professional relationship. Please ask our receptionist or billing manager if you have any questions about our fees or financial policy. 

Apple-a-Day Pediatrics S.C. is committed to providing the best treatment possible for our patients and we charge what is usual and customary for the Oswego area as determined by the major insurance carriers. You are responsible for payment regardless of any insurance company’s determination of usual and customary rates unless otherwise dictated by a managed care contract. Insurance is a contract between you and your insurance company. It is your responsibility to know your insurance plan benefits. You are responsible for the timely payment of your account. Failure to pay may result in further collection activity or dismissal from the practice. 

Our responsibility to our families: 

~ We submit all claims to your primary insurance company and accept assignment of insurance benefits.

~ We research information to process claims and answer questions about claims. 

~ We issue statements once insurance has made their payment determination. 

~ We accept payment by cash, check and most major credit cards.

~ We arrange payment plans when necessary.

                                                                                                   

Your responsibility to Apple-a-Day Pediatrics:

~ You provide eligible insurance information prior to each visit, notifying us of any changes. Failure to provide correct insurance information will result in charges being transferred to your responsibility.

~ You will notify us of any demographic changes. 

~ You pay your copay at the time of service. If you cannot pay your copay at the time of service, a $10.00 fee may be charged to you. 

~ You pay any outstanding balances that are unpaid, denied or delayed by your insurance carrier beyond 60 days after the date of service. Nonpayment may result in services being withheld. 

~ You will call your insurance company, if requested, to expedite payment for delayed claims before the 60-day limit has been reached. 

~ You will call your insurance company when a submitted claim was denied. Denied and disputed claims do not suspend your requirement to pay for services rendered.

~ You will be responsible for deductibles and non-covered expenses. This may include charges for screening forms that are required by law or recommended by the American Academy of Pediatrics. 

~ You will submit to Apple-a-Day Pediatrics any payment from the insurance company that is owed to Apple-a-Day.

~ You will pay a fee of $40.00 if a check is returned for insufficient funds. 

~ You will file claims with your secondary insurance company, if you have secondary insurance. Any balance due after primary insurance has been billed is due immediately to Apple-a-Day Pediatrics. 

~ You will pay in full for the office visit at time of service if insurance is not eligible or provided. 

 

Divorced/Separated & Co-Parenting Parents:

The parent or guardian who brings the child in for medical services is the financially responsible party. If there is a financial arrangement between the individual parental parties, this arrangement is between the two parties and does not absolve the parent that brings the child in for services from their financial obligation to our office. OUR OFFICE WILL NOT BE INVOLVED WITH SEPARATION OR DIVORCE DISPUTES. 

 

Minor Patients

Minors must be accompanied by an authorized adult. Please provide them with written authorization (accompanied by a parent/guardian signature) for our medical staff to provide care. We will deny non-emergency care unless a minor presents us with such authorization. The adult accompanying a minor and/or the parents or guardians are responsible for payment.

 

Cancellation and “No Show”

Please help us serve you, and all our patients, best by keeping scheduled appointments.

Late Appointments: If you are 10 or more minutes late for your scheduled appointment time, you may be asked to reschedule. If two appointments are scheduled together, please ensure you arrive for check in prior to the FIRST scheduled appointment. 

Missed Appointments: If you need to miss an appointment, please notify us 24 hours in advance or you will be assessed a $40 fee; If you miss your appointment, this is considered a No Show and will be assessed a $40 fee. If you miss an appointment that you scheduled on the same day, and it is not due to a visit to the emergency room or urgent care, then you will be assessed a $40 fee. 

In the event of 3 or more missed appointments or no shows occur, we may ask you to seek services from another practice and/or be assessed a $50 fee. 

After Hours

If you need to reach the on-call doctor regarding an urgent medical matter after regular business hours, please be advised that there may be a $25 charge if the call is not a result of an earlier office visit or if an office visit is not scheduled after the call. If you are calling for routine medical advice, appointments, or prescription refills, please call during normal business hours. If your call does require the physician’s immediate attention, please dial the on-call pager at 630-392-4512.

 

Well Child Services Agreement

At Apple-a-Day Pediatrics, we understand the importance of regular well child visits to ensure proper health care for our newborn, infant, child, and adolescent patients. The doctors and staff follow the guidelines of the American Academy of Pediatrics (AAP) to maintain your child’s health and safety. We protect our patients by following the vaccine schedule implemented by the CDC and performing the proper screening tests that are recommended at each stage of development. We do not accept new families who have made the decision to refuse or delay vaccinations into our practice.

Take the time to learn what services are covered for your children based on their age and your insurance plan. We recommended calling your insurance prior to wellness exams to know your benefits and coverage. 

There may be times when a child needs an additional office visit service during a well-child visit. This additional service will be billed to the health plan in addition to the preventative service that was rendered at the same time. Some health plans require you to pay a copayment or deductible for these additional services. When an insurance company issues an explanation of benefits with patient responsibility, our office will bill you in the same accordance. 

We understand the importance of your time and want to make the most of each appointment for your child. When time allows, we will address a concern that needs doctor’s care during preventative exams to reduce the number of trips to the office. Some services that may be provided and billed in addition to the well child exam include: 

The doctor’s work to address more than one minor problem (as noted above, an additional office visit service). Examples include ordering prescriptions, ordering tests, or changing the care plan for an established problem. 

Medical Treatments

Procedures

Testing outside the scope of AAP guidelines

Insurance billing is done in accordance with the services that are provided at the visit, so please do not be alarmed if you receive a bill for such services. We are happy to help if you have any questions.