INSURANCE & BILLING
Our Billing Office is open from 8:00am to 4:00pm, Monday through Friday. Please call with any billing or insurance questions and our knowledgeable staff will be happy to assist you. Understanding your health insurance plan’s benefits and restrictions has become a very difficult task in these days of managed care programs. We shall endeavor to assist you as much as possible; however, it does remain your responsibility to be aware of the details of your particular policy. Some of the limitations for you to be aware of may include: utilizing a specific lab or pharmacy, the requirement of obtaining prior authorization before being evaluated by a Specialist Physician, and the requirement of being “assigned” to our physicians in order for any payments to be issued. Not following your insurance company’s specifications often results in a family being responsible for payments that their insurance plan would normally cover. Please review your Plan Summary carefully, and contact your company’s Member Services department with any questions. Remember, your insurance coverage is a contract between you and your insurance company. Pediatric Associates of Stockton is not responsible for services denied by your insurance company.
Pediatric Associates of Stockton does have preferred provider contracts with several major insurance companies. Please contact your insurance company to determine if our practice is contracted with your insurance company. Any financial portion that is the “member’s responsibility” such as a co-pay or a non-covered percentage will be collected at the time of service. For plans with a deductible and/or co-insurance, a $30.00 deposit will be collected at the time of service.
If you do not make payment in full at the time of service, a $20 billing fee will be added to the account balance for a statement mailing.
If your insurance company does not have a contracted affiliation with Pediatric Associates of Stockton, or if you do not carry insurance, it is your responsibility to be prepared to make full payment for services provided, at the time of service. If it is the initial visit with our office, payment must be paid via cash, credit, or debit card. No checks will be accepted at the first visit.
As a returning patient, we are happy to accept debit or credit cards, cash, or personal checks for your convenience. Any requests for other payment arrangements MUST be made before the appointment. We are always happy to provide a billing copy for you to file with your insurance company for YOUR reimbursement, upon request.