BILLING AND FINANCIAL POLICY:
As a patient, you will receive comprehensive health care. Our fees will be related both to the amount of time a doctor spends with you and to the level of skill required to provide each service. We ask that you be prepared to pay for each office visit at the time of visit with cash or debit/credit card. A schedule of services and the fees charged for each visit is available. When situations arise in which a fee cannot be paid at time of service, arrangements must be discussed with the office manager prior to your visit.
Our office will be happy to file your charges for services rendered to your insurance company. If you are a participating member of a managed care plan, we will expect you to pay your co-pay and/or any other fees that are not covered at the time of your visit. If your insurance is one that we DO NOT participate with, you will be asked to pay in full for your visit upon check-in/check-out. IF your insurance pays us directly, we will reimburse you promptly for any overpayment that has been made.
Please understand that you are responsible for paying your bill on time regardless of the status of an insurance claim. All fees over 90 days past due will be subject to collection procedures and you may lose your eligibility to receive medical services from us. If circumstances beyond your control prevent you from being prompt in paying a bill, please contact the office as soon as possible so that a mutually acceptable plan of payment can be arranged.
Statements are posted monthly on your patient portal which may be accessed via our website www.GraysonPediatrics.com. Payment in full of patient portion will be expected upon receipt of your electronic statement, or at the time of your next appointment. Proof of current, valid insurance must be provided at the time of service. If you do not provide this information, you will be considered a self-pay patient. Past due amounts are subject to our collection process.
MEDICAL INSURANCE POLICY:
We participate with many different medical insurance companies. In addition, each of these companies offers many different types of plans. We make every attempt to accurately collect co-pays and deductibles. Understanding the health insurance benefit is the parent/guardian’s responsibility. Any patient who is seen and fails to notify our office of any changes in their insurance that in turn deems our services as non- covered will be billed directly for their charges. Any questions concerning your coverage should be directed to your insurance company. Your insurance policy is a contract between you and your insurance company, therefore, your balance is your responsibility. Should there be a dispute with your insurance company, our billing department will attempt to resolve it for you. During this time, the balance may be transferred to your responsibility.
NON-COVERED SERVICES POLICY:
Many parents are disappointed to learn that routine care isn’t always covered 100%. No standard “plan” of routine care exists today, either within the physician community or the insurance carrier community. As such, every insurance company has a different concept of what constitutes routine care, and they do not always follow American Medical Association or American Academy of Pediatrics guidelines. It is not possible for our office to keep up with what each company does or does not consider part of routine care. Grayson Pediatrics follows AMA and AAP recommended guidelines, and routinely performs certain tests/procedures that some insurance companies do not agree are part of recommended routine care. These tests will be billed to your insurance carrier, but if determined to be non-routine, and therefore non-covered, these charges will be the responsibility of the responsible party/patient guardian.
In general, our office is a point of service practice. You will be requested to remit your copay or the full office self-pay fee at the time of each visit. Copays are due at the time of appointment, and we are required to collect them at that time. Please remember that we are contractually obligated by your insurance company to collect your co-pay at the time of service. The balance of your charges will be billed.
SELF-PAY/CASH RATE POLICY:
Self-pay fees must be paid at the time of service; no exceptions can be made.
APPOINTMENT CANCELLATION POLICY
We understand that situations arise in which you must cancel your appointment. It is therefore requested that if you must cancel your appointment (via telephone), please provide more than 24 hours notice. This will enable another person who is waiting for an appointment to be schedule in that appointment slot. With cancellations via phone made less than 24 hours notice, we are unable to offer that slot to other patients.
Please understand that cancellations without the required notice will be treated as a NO SHOW, and your account will be charged as such. These fees are the sole responsibility of the patient/caregiver and must be paid in full before the patient’s next appointment can be scheduled. NO SHOW rules will apply to all late cancellations as well.
Please see the No Show/ Late Cancel Policy for further details.
NO SHOW / MISSED APPOINTMENT POLICY
Patients who do not show up for their appointment or arrive 15 minutes after their scheduled arrival time will be considered as NO SHOW. Patients who No-Show three (3) or more times in a 12-month period may be dismissed from the practice, thus they will be denied any future appointments. Additionally, patients who develop a history of late arrivals to their appointments may be dismissed from the practice. To avoid such fees please attend all scheduled appointments or call our appointment line at least 24 hours in advance to cancel the appointment.
Our practice firmly believes that good physician/patient relationship is based upon understanding and good communication. Questions about cancellation and no show fees should be directed to the Office Manager at 678-381-2630.
Our practice’s policy regarding no shows and late cancellations is as follows:
First no show: You will receive a phone call letting you know that you missed a scheduled appointment. If you cancel without required, sufficient notice, you will be informed during the call that insufficient notice was provided. A $50 fee will be assessed to your account for each prevention or sick appointment missed. These fees are not covered by your insurance and must be paid prior to you scheduling you or your child’s next appointment.
Second no show: The responsible party will receive a letter by mail informing them of the second missed appointment (within the allowed 12 months) and the assessed no show fee.
Third no show: The responsible party will receive a letter by mail indicating that they have missed a third scheduled appointment within 12 months, and all patients under the caregiver’s account will be dismissed from the practice. All no show fees will still apply.
The Cancellation and No Show fees are the sole responsibility of the responsible party and must be paid in full before the patient’s next appointment will be scheduled. No show/Missed Appointment fees are not covered by your insurance.
If multiple siblings are scheduled for back to back appointments, and no show their appointments, back to back scheduling will no longer be allowed. Future appointments must be made separately for each child.
PATIENT DISCHARGE POLICY
We want our patients and employees to be happy and healthy. We strive every day to make Grayson Pediatrics a warm and welcoming place. We have put a lot of thought and care into our No Show Policy and Billing Policy. Failure to comply with one or more of these policies is why most patients are discharged. It is important to read and understand these policies.
We acknowledge that we cannot be all things to all patients. Therefore, we reserve our right to discharge a patient from our clinic for failure to abide by our policies. All patient discharges are considered with great care; we do not make these decisions lightly. If you are discharged from the practice, you will be notified by mail with a certified letter. You will have 30 days to find another physician. We will provide acute care only during the 30-day window after discharge.