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Please bring your insurance card to each and every visit. We will be happy to file claims to carriers with whom we are contracted. All insured patients must present a current insurance card. Information that will be required to file your claims include the subscriber’s name, address, date of birth and phone number. We will also need the patient’s name, date of birth and insurance id numbers.
Co-payments are due at time of service. Effective 4/15/2017 a service fee of $15 will be applied per patient when co-payment is not paid at the time of service. You must pay before 11 pm on the date of service to avoid the service fee. For your convenience, we accept cash, check, Visa, Master Card and Discover.
HMO and PPO Coverage
We are contracted with most major insurance carriers. It is your responsibility to check with your insurance carrier to verify the following:
- Ensure the physician is contracted with your specific plan.
- Inform our office of any preferred laboratory required by your carrier.
- Know what services are covered by your plan.
You are responsible for any deductibles or co-insurance balances after your carrier pays their share.
Please note: If your insurance carrier does not pay your claim within 60 days, the balance will be your responsibility.
Pediatric Health Associates does accept Medicaid. Please contact HealthChoice Illinois at 877.912.8880 and choose one of our physicians as your child’s primary care physician (PCP). We are unable to see patients who are assigned to another primary care physician not affiliated with our practice.
Patients who do not have health care coverage or who have insurance coverage that Pediatric Health Associates does not have a contract with are required to pay in full at the time of service. We will be happy to furnish you with an insurance form to submit on your own.
Usual and Customary
Occasionally a non-contracted insurance company will make the decision that our standard fees exceed their interpretation of “usual and customary”. We have taken great efforts to base our fees in accordance with our physicians’ expertise, as well as the quality care provided at our facility or in the hospital. If your insurance company should arbitrarily decide that our fees exceed “usual and customary,” it will be your responsibility to pay any unpaid portion.