Prompt Appointments and focus on Patient Care

Billing Policies

We LOVE delivering quality pediatric and genetics care and enjoy the personal relationships we have with our patients and families. We must however recover charges for these services so we can continue to survive and thrive. This way we can continue to always “be there”, whenever you need us. Below is a list of our billing policies that will help us continue to deliver the highest quality medical care that you deserve. 

• We accept most select insurance carriers that recognize Clinical Genetics specialty and consider us In-Network. Please call the clinic to get an update for your specific insurance carrier.
• Co-payments, coinsurances, deductibles, and any charges for non-insurance covered services must be paid at the time of service.
• If you are unable to provide us with proof of coverage, full payment of your visit will be necessary at the time service is rendered.
• If you do not have insurance or are on a plan in which we do not participate, full payment is required at the time of your visit. We will supply any necessary information for you to file your insurance claim.
• You may charge your balance to your credit card. We encourage families to authorize Pediatrics and Genetics to charge a credit card for balances that appear on their children’s accounts. Authorization forms are available by clicking here .Simply print the form out, fill in your information and mail it, fax it, or bring it with you to your next appointment.
• Let us know if your family is under significant financial hardship. Payment plans can be arranged if necessary. We want to be sure that your family receives the care you need and deserve.
• We must have updated confirmation of your insurance and identifying information at every visit. It is your responsibility to let us know of any changes in insurance data, addresses, telephone numbers, etc. and to assure your insurance policy registered with Pediatrics and Genetics remains updated and active.
• We will bill the insurance company you designate for the services we provide. If we do not receive payment from your insurance company within 60 days, the balance transfers to your responsibility. You will be notified about any unpaid amounts
• If balances not covered by insurance remain unpaid by you after 60 days notification, we may need to reschedule routine checkup appointments.
• We may charge a nominal fee of $20 for completing complex forms. Our staff will advise you of this if this is the case with any request you make.

Cancellations / Late Arrivals / Walk-Ins

• Please call / email us 24 hours in advance if unable to keep your appointment. No Shows and same day Cancellations will be billed $25 to discourage disruption of patient care in the clinic.
• If you are 15 minutes late for your appointment, our staff will ask the doctor to help determine when best to see your child. You may be worked into the schedule with a wait, you may be given the next available appointment, or you may be asked to reschedule.  This will help us balance the needs of all of our patients.
• Walk-in patients will also be asked to wait for the next available appointment, except in the case of an emergency.

New Patients 

We ask all new patients to please arrive at least fifteen minutes in advance. Please register at our Secure Patient Portal to complete your registration and medical history at time of appointment request. Please bring relevant medical paperwork, including previous tests and clinical notes from prior physician visits.

You may also download the registration form from this site and fill out a paper copy and bring it with you. Please bring all relevant paperwork from your previous physicians, including prior genetic and laboratory test results.

Forms:

Registration
This form provides patient and insurance information. You may complete this form online, using our Secure Portal or fill out the Registration Form at home and bring it with you for your visit.  

Financial Policy:

This form acknowledges clinic financial policies. You may complete this online using our Secure Portal or complete the Financial Policy Form at home and bring it with you at time of visit.

HIPAA Agreement:

Health Insurance Portability and Accountability Act (HIPAA) passed congress in 1996 and provides guidelines for handling patient privacy. You may complete this through our Secure Portal Registration or complete the attached HIPAA agreement in at home and bring it with you for your visit. This confirms your understanding of clinic policies on HIPAA and your agreement on people that may have access to patient records.

Medical Records Transfer:

Request release of medical records into our clinic. For patients transferring from other practices to our clinic. 

Medical Records Release:

Request release of medical records to another physician or clinic.

Patient Referral:

Please use this for Physicians or Providers that would like to refer patients to our clinic. 

Clinic HIPAA Policy:

Provides information on clinic policies on handling patient records to comply with HIPAA 

Referrals :

For referrals supporting a genetics visit, please complete the Referral Form for Children or Referral Form for Adults and advise the referring physician that our office will be contacting them.