Policies & Insurance

Insurance

*We accept all PPO/Indemnity Plans affiliated with those networks listed above
*We accept all other PPO/Indemnity Plans not listed on an out of network basis

[1]  We do not accept BCBS Star plans

[2]  We do not accept Cigna Local Plus; Cigna Marketplace

[3]  We do not accept Humana Preferred or any HMO Plan

[4] Not accepting UHC Marketplace plans or Compass plans 

We DO NOT accept:

  • Medicaid
  • CHIPS
  • STAR plans, including Blue Cross Blue Shield
  • Sendero CHIP
  • Marketplace HMO plans
  • COBRA plans

We DO NOT accept any HMO plans thru the Marketplace Exchange, as the Insurance payers are not contracting at this time* Please also verify PPO Marketplace Exchange plans as well, we are not covered by MOST Marketplace Plans!

We DO NOT accept Blue Cross/Blue Shield HMO Medicaid-Superior, Medicare, or CHIP’s

We DO NOT accept any type of COBRA insurance plans

Policies

We accept VISA, MASTERCARD, cash or checks. Positive ID is required for all credit card or check payments. There is a $50.00 fee for all returned checks.

Patients that pay in full at the time of service will receive a 25% discount. You may then file a claim directly with your insurance company. We do participate in the TVFC vaccine program where vaccines can be eligible to uninsured or under-insured patients for $14.85. 

View our full financial policy here.

It is your responsibility to ascertain that your medical provider is a participating provider with your insurance company. If we are not in network with your insurance plan, you are responsible for the balance due after we have filed the claim and non-network benefits are applied to the balance due by the patient. 

A current insurance card and positive identification are required at each visit. The failure to provider the required information will result in forfeiture of the scheduled appointment unless cash or credit card payment can be made for the total charges of the visit. 

You are responsible for verifying benefits and coverage prior to any visit so that you are not billed for unanticipated charges. Some insurance companies do not cover some routine well services and/or non-routine services. Non-covered services will be billed directly to the patient. (Common exclusions: well visits, immunizations, hearing screens, visions screens, after hours phone calls)

Please be aware that your health insurance plan may not consider discussion and/or treatment of additional acute or chronic conditions or significant problems as a part of your child’s well check exam, which will focus primarily on preventative treatment. Discussing additional issues and/or symptoms of another medical condition or sick issues in a preventative well check exam can create another office visit fee and would result in additional charge and a co-pay or deductible/coinsurance amount depending upon your health insurance plan. Any charges not considered as part of the routine well child exam must be billed out as a separate charge code and you may be billed for those additional services. Questions about your insurance benefits should be directed to your insurance plan or your employer’s Human Resources department. 

Any outstanding balances that have not been paid within 60 days of filing a claim to insurance will be billed to the patient and must be paid 90 days of date of service regardless of the insurance status. Unpaid patient balances older than 90 days will be turned over to a collection agency. A collections charge will be assessed for these documents. 

PLEASE CALL FOR APPOINTMENTS, WALK-INS NOT ACCEPTED.

  • We attempt to make reminder calls for well-visits, but it is ultimately your responsibility to remember appointments.
  • Cancellations require 24-hour prior notice.
  • Cancellations with less than 24-hour notice and missed appointments will be assessed a $50.00 fee.
  • We schedule well checks at least one month ahead.

We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives. We firmly believe in the safety of our vaccines.

We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and the American Academy of Pediatrics.

Read more here