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Financial Policy

FINANCIAL & OFFICE POLICIES (Updated 2/7/2023)

USUAL AND CUSTOMARY RATES: Your insurance coverage and benefits are a contract between you and your insurance company. It is your responsibility to determine covered benefits. You are responsible for payment of any balance remaining after your claim has been processed, regardless of the insurance company’s determination of usual and customary rates.

INSURANCE COLLECTION: It is your responsibility to ensure that we have the most current copy of your insurance card, demographic and contact information. If your insurance is not verified at time of service, you are responsible for payment at time of service.

OUT OF NETWORK/NON-PARTICIPATING INSURANCE CARRIERS:  If your insurance carrier considers us “out of network” or does not participate with us, you are responsible for payment in full at the time of service.  We will gladly provide any proof of visit/receipts, etc.

CO-PAYMENTS: Payment is expected at time of service. Certain services are not covered by your insurance. For any questions regarding services/treatments, we encourage you to contact our Billing Manager and/or your insurance carrier to review costs. We accept all major credit cards, debit cards, cash, and checks. A $25 service fee will be charged to accounts for NSF/Returned Checks.

DEDUCTIBLES AND FEES:  Insurance deductibles are due at the time of service rendered. Failure to produce payment at check-in may result in your appointment being rescheduled. Patients with high deductible plans will be required to pay $50 at time of service for sick visits and consults.

WELL VISITS:  Preventative services include the Well visit (checkup) and other services that keep children healthy. If a child has a problem that is non-preventative needing to be addressed during the checkup, the provider will offer an additional service (Ill visit care) during the visit. This is a different service and is required to be billed to your health plan in addition to the preventative services provided on that day.  If you have co-payment, coinsurance or deductible amounts that you must pay before your health plan pays for these services, our office must charge you these amounts in accordance with the contracts that we have with your health plan.  

DIVORCE DECREES:  In the case of services provided for minors, the individual who initiates services for the child will be responsible for payment.  This office is not a party to your divorce decree.  We do not bill another individual or estranged spouse for payment.  Copayment is due at the time services are rendered from the person accompanying the patient.  If the divorce decree requires the other parent to pay all or part of the treatment, it is the authorizing parent’s responsibility to collect from the other parent.  West Side Pediatrics will not act as a mediator in collecting our payments.

PAST DUE PAYMENTS:  We expect you will make every effort to pay your bill promptly. If you have a financial hardship, or if you are unable to pay your bill in its entirety, please contact our billing office to discuss payment options.  If your account becomes delinquent (past due 60 days) it will be subject to interest, rebilling fees, and collection costs.  Should collection action become necessary, the responsible party agrees to pay collection fees, and all legal fees of collection, with or without suit, including attorney fees and court cost.  No balance over $300.00 can be carried on a family account without a scheduled payment plan.

NO SHOWS/LATE ARRIVALS: If you arrive more than 15 minutes past a scheduled appointment time, we may have to reschedule the appointment. If you are unable to attend a Sick visit, we require at least 2 hours notice. This includes same day sick visits. If you are unable to attend a Well Visit or Consult, we require at least 24 hours notice. The first missed visit will add a warning to your account, the second missed visit will incur a $30 office fee, and if you miss 3 appointments without proper notification in a 12-month period, the practice will no longer be able to provide healthcare services to you and will dismiss you from the practice. 

AFTER-HOURS, WEEKENDS & FEDERAL HOLIDAYS FEES: For your convenience, WSP offers extended evening, weekend, and Holiday hours. A fee of $25 will be added to visits taking place after 5pm, on weekends or Federal Holidays. This fee is billed to your insurance first, though it can be applied toward your deductible. You will receive a bill from this office to apply the fee toward any remaining deductible you have.

CARE WHEN THE OFFICE IS CLOSED: If you need to speak to a triage nurse after the office has closed regarding an urgent clinical concern, or whether your child needs to be seen in the Urgent Care or Emergency room, please be advised that your call will be assessed a $20 fee.

PORTAL/PHONE COMMUNICATION: Portal messages or phone calls that require a provider’s medical expertise and meet certain requirements (see conditions listed on our website at WSPCincy.com) may be charged. This service will be billed to your insurance. If you have a high deductible plan, the cost may be charged to you as part of your deductible.  

 

*Authorization will expire if: a) the minor listed above receives a new legal parent/guardian, b) the minor listed above turns 18 years of age, c) the adult patient listed above ages out of the practice, d) the patient listed above is no longer a patient of West Side Pediatrics. The patient or their legal parent/guardian may revoke this authorization in writing at any time. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you/your child.

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Our Regular Schedule

Delhi Office Hours

Monday:

8:15 AM – 7:00 PM

Tuesday:

8:15 AM – 7:00 PM

Wednesday:

8:15 AM – 7:00 PM

Thursday:

8:15 AM – 7:00 PM

Friday:

8:15 AM – 4:30 PM

Saturday:

8:15 AM – 1:00 PM

Sunday:

CLOSED

Taylor Creek Office Hours

Monday:

8:15 AM – 7:00 PM

Tuesday:

8:15 AM – 7:00 PM

Wednesday:

8:15 AM – 7:00 PM

Thursday:

8:15 AM – 7:00 PM

Friday:

8:15 AM – 4:30 PM

Saturday:

Closed

Sunday:

Closed