Billing & Insurance

Primary and Sub-Specialty Care

Our primary goal as providers of health care services to your children is to deliver outstanding clinical care and service. We are open seven days a week and are on call 24 hours a day every day. Depending on your insurance plan, there may be an additional fee for After Hours Care.

We strive to serve our patients efficiently and effectively. In order to achieve our goals, we request that each patient do their part in cooperating and adhering to the policies of our practice regarding insurance and payment.

FULL PAYMENT FOR ALL COPAYS, DEDUCTIBLES AND NON-COVERED SERVICES ARE EXPECTED AT THE TIME OF YOUR APPOINTMENT.

ALL SERVICES WILL BE BILLED TO YOUR INSURANCE. THE PATIENT IS RESPONSIBLE FOR ALL CHARGES APPLIED TO THEIR COPAY, DEDUCTIBLE AND NON-COVERED SERVICES BY THEIR INSURANCE.

ALL PAYMENTS ARE REQUIRED TO BE MADE AT THE TIME OF SERVICE IN THE FORM OF CASH, CHECK OR CREDIT CARD. PAYMENTS ARE ALSO ACCEPTED ONLINE VIA OUR SECURE WEBSITE.

  • Know your insurance plan benefits pertaining to pediatric well and sick visits.
  • Know what’s covered. Not all services are a covered benefit (often well-exams and immunizations are not). It is your responsibility to be aware of your insurance company’s plan provision for payment of office visits, immunizations, well-child exams, and routine annual exams including school, camp, or sports physicals.
  • Know if there is a co-payment.
  • Know if there is a deductible and the amount of the deductible.
  • Notify your insurance company and your Employer’s Human Resources Department, of the birth of any new baby within 30 days of their birth.
  • If you are a member of an HMO, choose “Pediatric Associates” as your primary care physician.
  • Carry your insurance card and present it to the Receptionist at the time of service.
  • Make full payment of office visit co-payments, deductibles, coinsurance, and non-covered expenses at the time of your office visit.
  • Advise the staff of any changes in address, home or emergency telephone numbers and insurance coverage at check in.
  • In the event that you do not have insurance coverage, please inquire as to our reasonably set fees when scheduling your appointment.
  • If you have a previous outstanding balance and now have new insurance to cover your current charges, you are still responsible for the PREVIOUS OUTSTANDING BALANCE and may be subject to collection, if not paid, despite any new insurance.
  • If your insurance coverage makes a partial payment and you are responsible for the balance, or if you have any outstanding balance, full payment is expected in a timely fashion, but no later than 30 days from the receipt of your statement. If you must make alternate payment arrangements, please call our Billing Department promptly at 888-313-9010.
  • Pay for returned checks: If your bank returns a check without sufficient funds, you will be responsible to reimburse us for our financial institution’s fee of $25 per check.

Insurance

We participate with most major insurance companies, including Florida Medicaid and Healthy Kids programs. However, each company offers many different plans. Pediatric Associates may not participate in each and every one.

We recommend that you contact your insurance company, prior to making your appointment:

  • To verify that we are a participating provider on your specific plan.
  • To verify if your plan requires you to select a Primary Care Provider (PCP).  If so, verify your Pediatric Associates Physician is the assigned PCP.
  • To verify your co-payment for primary care and specialty services.
  • To verify if you have a deductible and request an estimate regarding your out-of-pocket costs for the office visit.

Please contact our Billing Department if you have any other questions at 888-313-9010.

We currently accept:

  • Aetna – HMO, PPO, POS, QPOS, Select
  • AvMed
  • BCBS Florida Blue – PPC, PPS/PHS, Network Blue, Blue Options, Health Options
  • Best Choice (Broward Health)
  • Cigna
  • Coventry – HMO, POS/Open Access, PPO, Individual, National, Network Access, First Health
  • Humana – HMO, POS, PPO, EPO, Open Access
  • Multiplan (Beechstreet, PHCS)
  • Memorial Health Network – MHS Employees (MMCP, MCHP, CCP/CCP+)
  • PPO Dimensions
  • Preferred Medical Plan
  • Tricare (Humana Military)
  • United Healthcare – HMO, PPO (including Options PPO, United Neighborhood, Golden Rule, UHC One)
  • Amerigroup
  • Better Health PSN
  • Coventry
  • CMS XIX & XXI
  • Humana
  • Molina Healthcare
  • Medicaid
  • Prestige Health Choice
  • Simply Healthcare
  • South Florida Community Care Network (SFCCN)
  • Sunshine Health
  • United Healthcare
  • Wellcare/Staywell
  • Amerigroup
  • Coventry
  • Sunshine Health
  • Wellcare/Staywell
  • Coventry Carelink
  • BCBS Health Options HMO
  • BCBS Blue Options PPO
  • Molina Marketplace
  • Preferred Medical Plan
  • Sunshine Ambetter
  • United Healthcare Compass

Florida Patient’s Bill of Rights and Responsibilities

For additional information on the Rights and Responsibilities of Patients, please review Florida Statute 381.026 Florida Patient’s Bill of Rights and Responsibilities:  http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0381/Sections/0381.026.html