FREQUENTLY ASKED QUESTIONS
Q: Can my child be seen without an insurance card?
A: We require that you bring your child's insurance card to each visit. If you do not have your card, having the name, dob, SS# and employer of the policy holder may allow us to verify your insurance. If we are unable to verify your insurance, you will be expected to pay at the time services are rendered for the charges incurred.
Q: What is an Insurance Balance?
A: A visit that has been filed with your insurance company and is pending payment.
Q: What is COB?
A: COB stands for Coordination of Benefits. Most insurance companies send out a yearly questionnaire inquiring if you have any other insurance coverage. It is your responsibility that your carrier has the most current information. If a claim is denied due to COB issues- you will be responsible for the bill.
Q: What is EOB?
A: EOB stands for Explanation of Benefits. An EOB provides necessary information about claim payment information and patient responsibility amounts.
Q: Do you bill for "Secondary" insurance coverage?
A: Yes, for certain payors we do. Should you wish to file with another secondary carrier, we will supply you with the necessary statements to do so.
Q: Why does it take you six months or longer to bill me for something the insurance company did not pay for?
A: We do bill as soon as we can after the insurance company has issued its final determination (EOB). Therefore, it could be nearly six months before we send you an updated statement.
Q: Why am I sometimes charged two copays for a single visit to my doctor?
A: Insurance companies distinguish between diagnosis codes – particularly between what they consider a well code or a sick diagnosis code. A well visit constitutes monitoring of a child’s growth, development and anticipatory guidance. If during your child’s well visit other topics of what an insurance company would consider a sick diagnosis i.e., headache, acne, asthma, chronic illness; are also discussed, the encounter is actually recognized as two “visits” and therefore two copays may be deemed necessary.