Here at Starks Pediatrics, we are doing everything possible to hold down the cost of medical care. You, the parent, can help a great deal by eliminating the need for us to charge and/or bill you for any reason. The following is an explanation of our Financial Policy. Please be sure to read the entire passage.
Payments of co-pays, deductibles and other patient portions are expected at check-in before any services are rendered. This includes any balances related to administrative fees due to missed appointments, late cancellation/rescheduling of appointments, and medical records. For your convenience, we accept cash, checks, Visa, MasterCard, Discover, and American Express. There is a $25 service charge for all returned checks.
You must bring a valid insurance card to every visit. Your insurance will be verified prior to each visit and if we are unable to verify active coverage, any and all fees for your services will be collected before any services are rendered. Insurance claims are filed with the participating plans where a valid insurance card is provided. You must report any insurance changes to the office as soon as possible. Any information that is inaccurate, or received after the date of service may not be billable to the insurance carrier, and may become the responsibility of the account guarantor.
When adding a newborn to your insurance plan, please check with your Human Resources department about requirements of your particular plan. If your child’s insurance coverage is not in place at your initial visit, payment will be collected before any services are rendered. Once you have received the child’s insurance card, bring it with you to your next appointment.
Many insurance policies require prior approval or authorization for tests, procedures, specialist referral visits or hospital admissions. While we try to determine and meet these requirements, we ask for your assistance as well in order to ensure timely filling and payment of insurance claims. It is the responsibility of the policy holder to know and understand these requirements in order to avoid any costly penalties and denials by your insurance carrier.
Requests for medical records require a signed Medical Release Form stating the authorization of release from Starks Pediatrics to either the parent or the current Dr’s office. All medical records will be subject to a processing fee and will only be released after the fee is collected. In addition, if there remains a balance on your account, any and all medical records, less the immunization records, will not be released until the balance is resolved.
Missed appointments and late cancellations/rescheduling represent a cost to us, to you and to the other patients who could have been seen in the time set aside for you. We require at least a 24 hour notice for any cancellations or rescheduling of every appointment made. Failure to cancel or reschedule 24 hours in advance will result in a $25.00 administrative per appointment.
If you are a recipient of Medicaid, you must adhere to the policies of the Medicaid Program. We at Starks Pediatrics will only accept Medicaid patients with a valid, active recipient ID number, which we will verify before any services are rendered, or with a valid Medicaid Card. Our staff has no access to Medicaid Recipient ID numbers, unless provided by the parent/legal guardian. If the Medicaid recipient ID number is returned to us as Inactive, Unknown, Missing, Invalid, or Not Found for any reason, any and all charges will be collected before any services are rendered.
If your child is a newborn, and the Medicaid recipient ID number has not yet been processed, you can still see the physician, however any and all charges will be collected before any services are rendered, and will not reimbursed at a later date. It is our policy at Starks Pediatrics that we do not accept Medicaid Pending or Medicaid for Pregnant Women (MPW).
If your Medicaid recipient ID number or Medicaid card has another Physician/Facility listed as the Primary Care Physician (PCP), then you, the parent/legal guardian, must call your case worker and request that your PCP be changed to Starks Pediatrics for any future appointments. We are allowed to see you child for up to 1 month while that change is in process. After one month we are not allowed to see your child if another Physician/Facility is listed as the PCP. The staff of Starks Pediatrics cannot make this change for you. The Medicaid Program will only accept requests for changes in the PCP from the parent/legal guardian. While another PCP is listed on your card, Starks Pediatrics has to seek authorization from that PCP in order to provide service. If we are unable to obtain authorization for treatment from the listed Physician/Facility on the policy/card, any and all charges will be collected before any services are rendered.
It is our policy at Starks Pediatrics that if your child has active Medicaid coverage and active private insurance coverage, under no circumstances are we allowed to accept or bill to the Medicaid policy. Co-pays and deductibles for the private insurance plan are not covered by the Medicaid Program and therefore will be collected before any services are rendered. Any claim denials from the Medicaid Program due to active private insurance coverage can prevent us from filing the medical claims to the private insurance in a timely manner, and can become the responsibility of the account guarantor due to non-compliance to the Medicaid Program and the private insurance policy.
The Medicaid Program does not cover any charges due to administrative fees. This includes the fees that are incurred due to late cancellation/rescheduling of an appointment, missing an appointment altogether, and print-outs of medical records. If you have any problems or questions related to the Medicaid Program Polices and Guidelines, you can call the Medicaid office at (704) 512-5555 or (888) 671-7437.
If a balance remains on your account beyond 30 days following the date of services rendered, regardless of pending insurance payment, it is considered delinquent and the account guarantor will become responsible for payment of the entire remaining balance prior to scheduling any appointments, unless arrangements have been made with our Billing Manager.
If your account is delinquent beyond 60 days following the date of services rendered, it will be turned over to a collection agency, you risk reporting of that information to national credit bureaus, all future appointments will be canceled and no further appointments will be scheduled until the balance of your account is paid in full. In addition, the account guarantor will be responsible for any collection’s and attorney’s fees and any cost or expense associated therewith. You will be dismissed from the practice if your account is placed into collections. No further medical service of any kind will be given to anyone with an account placed into collections, including telephone advice.
If you are in need of assistance or have any questions regarding your fees, payments or statements, please contact your insurance carrier first, and then contact Starks Pediatrics and ask for the Billing Manager. All questions related to billing will not be addressed by the physician during or after your appointment. Your physician’s role is to provide the best medical service possible and therefore, the full responsibility for billing concerns will be addressed with the Billing Manager before services are rendered. Should you have any comments or complaints regarding the Financial Policy or procedures that remain unresolved, please feel free to check out our website, and on the Contact Us. page you can leave your comment or complaint.
Thank you for taking the time to read our Office Financial Policy.
| Telephone: | (704) 717-2826 |
Clinic Hours:
M-Th 8:30am - 5:00pm, Fr 8:30-12