Billing & Insurance

Boutique Medical Care

Petite Pediatrics provides Boutique Medical Care, also known as “concierge medicine.” We provide a medical home for patients with a mutual patient-physician focus on preventive care in a small practice setting.  Although we contract with PPO insurance companies, there is a direct arrangement between the patient and primary care physician in which the patient (parent or responsible party) enters into a “direct” financial relationship with the physician for non-medical services related to a patient’s overall care. This is provided through our Peapod Membership Program:

PeaPod Membership Program

The Peapod Membership Program is a per family annual fee charged to secure certain administrative and communications services only. These benefits result in superior, prompt, and enhanced pediatric medicine and physician access. The annual fee does not cover the cost and charges for health care or medical services provided. You and/or your health insurance provider shall be financially responsible for all physician and staff health or medical charges.

Billing & Insurance

It is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive. You are financially responsible for the medical services provided.

Petite Pediatrics participates with a limited number of insurance plans. You may contact our office or your carrier to determine if Petite Pediatrics is within your provider network. Of note, we will accept all PPO insurance plans as an out-of-network provider. We do not accept HMO insurance plans.

Fee Schedules

The fee schedule for insurance billing has been designed to represent the usual and customary charges in a pediatric medical practice. It reflects time spent, supplies needed and the complexity of the problem and/or procedure. The fee schedule for the Peapod Membership Program is an annual per family fee based upon the number of children cared for at Petite Pediatrics. It is not billed to insurance. Details regarding our fee schedules are available to current and prospective patients through the office directly.

Payment

We will be implementing a Patient Insurance Estimator system in 2019. This will estimate the patient responsibility for medical services based upon your insurance plan and will be due at the time of service.  We accept payment in the form of cash, check and credit (Master Card, Visa and Discover).

An online bill-pay feature is available through the Patient Portal. There will be a $45.00 service charge for all returned checks.

Financial Policy

You are responsible for payment at the time services are rendered. If someone other than yourself is responsible for the bill, such as a divorced spouse, we will provide a statement that you can use for reimbursement purposes. Payment is expected from the person who brings the child in for services, and we do not get involved with billing other persons or waiting for the conclusion of court cases.

We realize you may have financial problems, at times, making immediate payment difficult. Please feel free to discuss this with us prior to the scheduled appointment so that payment arrangements can be made. While we are concerned about our collections and expenses, we do not intend to jeopardize your child’s medical care. We always try to honor a faithful relationship.

Past due amounts that are greater than 90 days over due are subject to being turned over to a collection agency and termination from our practice could result. You are strongly encouraged to pay all past due amounts promptly or set up a payment plan with us.

There is a $45.00 charge for returned checks. If two (2) checks are returned, you will no longer be able to write checks in our office. Payments must be made either by cash, credit card, money order, or certified check.

No-Show Policy

Please inform our office within 24 hours of your scheduled appointment  if you are unable to make the appointment. After one (1) no show, you will be notified by our office. After a second no show, you will receive letter a $45.00 charge will be added to your account. Insurance will not pay for this charge.  After a third no show, your account will be reviewed and we will attempt to contact you directly by phone to determine the cause of the missed medical evaluations.  Please be aware that multiple missed appointments may result in the involvement of Public Health Services and/or Child Welfare Services, and/or dismissal from the medical practice.

Boutique Medicine and Insurance

Many families obtain a high-deductible PPO insurance policy that will provide catastrophic coverage but allow you to use the money you save on the lower monthly premiums to obtain the kind of high-quality personalized care you and your children desire and deserve.

Additionally, families may also optimize the use of Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), or Health Care Reimbursement Accounts (HCRAs) if offered by their employer, which allows them to set aside pre-tax dollars for medical services not covered by their insurance.

Please note: This information is offered for informational purposes only and is not intended to be used for promotion of insurance or banking programs.