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Insurance
We will gladly bill any insurance as a courtesy to you, but keep in mind that insurances outside our contract network often accept less than our billed charges, even if they advertise “100% benefit.” In some cases this is directly related to the contract your employer has made with them. If your insurance company is NOT on our “in-plan provider” list, we will balance bill you for any portion of the charges not paid for by your insurance in the end.
Preferred provider (aka “in-plan provider”) means that we have entered into a contractual agreement with the insurance company regarding payment for their beneficiaries. We are participating or in-plan providers for:
AETNA
Blue Cross / Blue Shield
Cigna
Denali Kid Care / Medicaid
Tricare
MultiPlan Network
Your Responsibility
Newborns — We recognize that sometimes it takes a few days to get your newborn added to your insurance policy, so please let us know as soon as final arrangements have been made with your insurance carrier. As a courtesy to you we will hold billing the total charges to your insurance for up to 30 days if necessary. Anticipated copays or coinsurances that apply may be collected in the meantime. If your child has not been added to your insurance within 30 days, the accumulated charges will become your responsibility. Please notify us in advance if extenuating circumstances prevent you from meeting this deadline and we will be happy to work with you.
We allow 30 days for NEWBORNS to be added to policies before assigning responsibility for the bill to the parent. For all other patients: If you cannot provide us with active insurance information, we expect payment at the time of service. If you provide us with insurance information later that covers that date of service, we will be happy to file for you and refund you if a credit remains after your insurance carrier has finished processing our claim.
Insured – Each insurance plan is different and some policies change with eye-popping frequency. We will attempt to verify insurance eligibility before your appointment, but we encourage you to become familiar with your own benefits before your appointment to avoid any surprises. Any dispute arising from what is covered by your plan and what you are responsible to pay for is best resolved between you and your specific carrier, ideally before you make the appointment. Limits to what your insurance pays for any type of visit may result in you owing a balance even after your expected coinsurance or copay has been paid. Remember, that you assume all responsibility for any billed charges that your out-of-plan insurance provider does not cover.
Billing Statements — We send out monthly statements in the event that you end up owing a balance on your account. Your prompt attention to these bills is greatly appreciated. You may remit payment by check or credit card via in the enclosed envelope. Or you can pay online 24/7 at the link below. You can also call our office and pay by credit card over the phone.
If you have a balance too large to pay in one payment, ask us about using our Repetitive Payment Authorization Form to set up a payment schedule that will allow us to deduct your pre-determined monthly payment from your Visa or Mastercard for you. We are happy to work with you.
Accounts significantly overdue without acceptable arrangements being made may result in the charges being sent to collections, after which appropriate arrangements must be made before your child can be seen in our clinic again. Please avoid this by at least calling our office to discuss options. We want your children to receive quality medical care and will do what we can to work out payment options that fit your needs and preserve your credit.
Co-pays and Deductibles
Any applicable co-pays are collected at the time of service as required by your insurance company. All applicable co-insurances and deductibles are due at the time of service as well.
Self Pay
We offer a 20% “Prompt Pay Discount” for patients who are uninsured or wish to pay their billed charges in full at the time of service. FINE PRINT: Specially priced school / sports physicals are not eligible for this additional discount.
We accept Visa/MC, personal checks, and cash. Exact change (or close) is appreciated if paying in cash as we keep very little cash on hand.
Ptarmigan Pediatrics is proud to support our military. All our providers can be selected as “Primary Care Managers” (PCMs) for the families of active duty military personnel. This allows Tricare Prime members to obtain pediatric medical care at our location without a referral or “prior authorization” and without driving to the military hospital. Other Tricare plans, such as Tricare Standard and Tricare Reserve Select, do not require a PCM, and may be subject to applicable co-pays, deductibles, and/or cost shares as required by those plans. We’re happy to be your choice for these services.
Insurance Links
