Billing FAQ
Payment for health care is very complex. Our staff is highly skilled and will be pleased to help you with your questions and problems. You can help our office if you:
Bring your insurance card with you to every visit.
Be familiar with your plan’s co-payment or deductible requirements.
The insurance companies require Covenant Pediatrics to collect your copay at the time of your visit. The money is partial payment for services rendered when you bring your child to the doctor. The insurance company subtracts this payment from what they will pay the doctor and they expect you to have paid your copay at the time of the visit. If the copay is not paid before statements are sent out, there is a billing fee of $10 added to the amount owed for the copay to offset a portion of our processing fees.
Why am I asked to call my insurance company to verify my coordination of benefits (COB)?
The insurance company needs to verify that you do or do not have other insurance coverage. From time to time, coverage changes and insurance companies need to update their records and will not pay your doctor until the verification has occurred. If you are covered by more than one insurance policy, payment from each is determined by which is considered the primary insurer and which is secondary. To update/verify your COB information normally requires you to call your insurance company’s customer service representative and update the information over the phone. After we contact you to inform you that you need to call your insurance company, if they continue to not pay for services rendered by our doctors for your child’s care due to a COB issue, we will transfer the balance unpaid by insurance to your account in the next billing cycle (every 28 days).
Why might I get a bill/statement if I paid my copay at the time of service?
Depending on your Insurance Policy, you may have other costs that include coinsurance, out of pocket maximums, and/or deductibles.
Why might I get a bill for a copay if my child was seen for a well visit when my health plan covers those 100%?
If your child is treated for something that is not part of a regular well visit, your insurance company considers this a separate charge. An example of this might be that you bring your child in for their yearly well visit and they also have an ear infection, or sinus infection and you need an antibiotic. Your insurance company will not pay the copay for the part in which you need the antibiotic since they consider that an office visit.