Billing Policies
 •The
parents must update new address and phone information with the
front office staff. Failure to do so will result in statements
being undeliverable and may result in accounts being sent to collections.
Current Insurance:
• We verify
general insurance benefits prior to your child being seen by
our providers. We require that you present your
current insurance card at EVERY visit so that the office staff
may scan it. Failure to update our office with correct insurance
information on the date of service will result in the charges
being billed to the patient. We are not able to bill new insurance
if it is not provided to us in a timely manner.
• Our office
staff is only given a quote of benefits by your insurance company.
It is never a guarantee of payment. We
do our best to verify all vaccines and office visit co-pays and
deductibles; however ANY portion that is applied to patient responsibility
by the insurance company is due in full at the time of service.
If you have any questions about your benefits we recommend you
contact your insurance company so that they can explain your
benefit package to you.
Payment:
• We collect
all copays and deductibles at the time of service. Statements
will be mailed out monthly for any portion
due that insurance may apply and payment in full is expected
on receipt. All account balances MUST be paid prior to any Well
Child Exam. Please review statements to insure accuracy from
all parties. We accept cash, personal check and all major credit
cards (Amex, Visa, MC and Discover) for your convenience.
Collections:
• If you have
a question about your account please call our billing office
at 817-698-9196 and speak to someone in the
billing department. We are happy to assist you in any way that
we can.
• Accounts that
remain unpaid will be sent to a collection agency for further
collection proceedings and will result in
patients being dismissed from the practice.
Refunds:
• Refunds are
issued twice a month. Please allow ten business days to process.
Refunds will not be processed by credit card
transactions. All refunds will be issued by paper check.
Newborns: • Please
be aware that not all plans cover newborns with automatic coverage
and patients may be asked to pay for the visit
in full if our office staff is not able to verify coverage for
the date of service.
• Newborn charges are often put to patient responsibility
because the baby has not been added to the health plan. It is
the parent’s responsibility to contact our office once
the baby is added to the policy so that we may submit the charges
to the correct insurance and they are processed correctly. If
the parent fails to contact the billing office within filing
time limits, the charges will remain patient responsibility.
Please call your insurance to add newborn within 30 days. Failure
to add newborn child within 30 days may result in the child being
denied coverage until the next enrollment period for the plan.
 Well Child Exams:
• Please be
aware that a physician may bill a sick office visit (99202-99205,
99212-99215) in addition to a previously
scheduled preventative visit. Per CPT coding rules the well child
visit code applies only to preventative medical care but does
not include any issues related to chronic diseases or acute illness.
Insurance companies process these claims according to their policy
guidelines and the patient may have a balance due for the unrelated
sick office visit.
• All labs,
hearing screen and vision screen are billed separate from the
preventative office visit. Please be aware
that each policy processes these charges according to your benefit
guidelines and the patient may receive a bill for these services.
State Vaccines:
•If
you are aware that your insurance plan has a max benefit for
well care and wish to receive state vaccines, please ask at
the check-in window to make sure you will be receiving state
vaccines. If you do not verify and pay for the state vaccine
administration
before leaving the office, and private vaccines were given,
the balance
due for the private vaccines will be the patient's responsibility.
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