601 5th St South -  Suite 708
St. Petersburg, FL 33701
(727) 767-4146 Fax (727) 767-4272

 

 

 


 

Financial Policy

Pediatric Pulmonary Associates
Financial Policy
Effective: July 1, 2011

We believe that communicating our financial policy is a good healthcare practice. Charges incurred for services rendered are the patient’s responsibility, regardless of insurance coverage. Your insurance coverage is a contract between you and your insurance company, not your insurance company and us. We will file your primary and secondary insurances. Please realize that having a secondary insurance does not necessarily mean that your services will be covered at 100%. Secondary insurances typically pay according to a coordination of benefits with the primary insurance. It is your responsibility to provide us with accurate insurance information and to inform us of any changes as they occur.

You are responsible for all copays, coinsurance, deductibles, and non-covered services/items. We are obligated to collect your copay at the time of service per your insurance company. We accept cash, check, Visa, MasterCard, American Express or Discover. Statements are sent out monthly, and we ask that payment for balances due be rendered upon receipt of your statement or at your next appointment, whichever is sooner. There is a $25.00 returned check fee.

When you receive healthcare services from us and we bill your insurance, it is the same as us extending you credit. You receive the service and we await payment from you and/or your insurance company. Due to the high cost of rendering care and the lowering reimbursements by many insurers, balances not paid within 90 days, may be turned over to an outside agency unless prior arrangements have been made.

We are happy to work with our patients to set up a mutually feasible payment plan if needed. Please understand that we cannot waive deductibles, coinsurances or copays that are required by your insurance. This is a violation of our contracts with the insurance plans.

Completing disability forms, FMLA forms and other requested supplemental forms can take up to 5 business days to prepare. There is a $10.00 fee for this service due prior to release of documents.

Patients that do not show up for an appointment and do not call to cancel or reschedule have impacted another patient’s ability to be seen. We require a 24 hour notice of cancellation for all scheduled appointments or you may be billed a No-Show fee of $10.00. After repeated No-Shows without notification you may be discharged from the practice.

Laboratory, Radiology and other Diagnostic Services:

These services will be billed separately by the facility that performs these tests and are not covered by the payments that you make at this office. Any insurance claims or problems associated with a facility other than Pediatric Pulmonary Associates must be dealt with through that facility or their billing agent.

I have read, understand and agree to the above financial policy. I understand that charges not covered by my insurance, as well as applicable copays, coinsurances and deductibles are my responsibility. I authorize my insurance benefits to be paid directly to Pediatric Pulmonary Associates, and I authorize them to release any pertinent medical information to facilitate payment of a claim.
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