We are committed to providing and maintaining the best possible care for our patients. Your review of our office financial policy in advance allows for good communication and enables us to provide the highest-quality service to your family.
At the time of each appointment, please provide your insurance card, current mailing address and copayment and/or deductible. If you are unaware of your specific insurance plan's copayment/deductible information, please call your insurance company prior to your appointment to find out what you will be responsible for at the visit.
Payments Due at Time of Service
Office services are payable at the time of service. This is an insurance company policy, which includes all applicable copayments, coinsurance and/or deductibles from participating insurance companies. We accept cash, checks, MasterCard, Visa and Discover.
Your Insurance
We participate with numerous Insurance companies including local HMO plans. If your plan requires you to list a primary care physician (PCP), you must list one of our providers as your child's primary care physician prior to being seen in order to prevent billing issues. If there is no PCP listed at the time of your visit, you will be asked to contact your insurance company to list a PCP prior to being seen that day. Please be aware that some insurance companies do not pay the entire doctor’s bill; therefore, you may be responsible for the bill.
Non-Participating Insurance Companies
If we do not participate with your insurance, we will submit claims on your behalf as a courtesy. If your insurance company does not pay within 45 days, you will be responsible for the balance.
Copayments & Deductibles
During a visit to our office, patients may receive several different kinds of services; each service may have a separate charge. By addressing new or established issues during a preventive care exam or “check up," we hope to avoid any inconvenience or additional visits. Your insurance company may require that you pay a copayment, coinsurance and/or deductible for these services. This is due at the time of the appointment.
Non-Covered Services
In the event that your health insurance company determines a service is "not covered," you will be responsible for the complete charge. Should this occur, we will personally bill you for the services. Payment is due upon receipt of that statement.
Vaccinations
Please determine in advance if your insurance plan completely covers immunizations. We participate in the Vaccines for Children (VFC) program, which provides immunizations for children at no cost to you. However, if your insurance plan does not cover immunizations or you have no insurance coverage, you will be responsible for an administration fee of $17.85 for each immune.
Medicaid and Medicaid Managed Care
We participate with NYS Medicaid and Medicaid Managed Care insurance plans. If you are required by Medicaid to select a managed care plan, please make sure you inform our office of your selection.
New York State’s Child Health Plus
Any uninsured child that is not eligible for Medicaid automatically qualifies for New York State's Child Health Plus. The office staff will be glad to provide you with an application form.
Workers’ Compensation and No Fault
If you have sustained injuries in a work-related or motor vehicle accident, please notify us upon check-in at your appointment. All no-fault and workers’ compensation information should be given to us at the time of first treatment prior to being seen including insurance company's address and phone number and the claim number. By law, no-fault claims must be filed within 45 days. If you do not supply Amherst Pediatric Associates with this information, you may be responsible for the entire payment. In the case of workers' compensation accidents, please notify your employer of the injury.
Minor Patients
Please note that all patients under the age of 16 must be accompanied by parent/guardian. The parent/guardian accompanying the minor patient will be responsible for payment of all services rendered. Our concern is for your child’s growth and development. Amherst Pediatric Associates will comply with all binding custodial legal agreements.
Past-Due Accounts
An account is considered past due if no payment is received within 30 days of the initial billing date. Patients with past-due accounts must make a payment before the next appointment with their health care provider. Accounts that remain delinquent will be forwarded to a collection agency.
Payment Arrangements
If you are unable to make full payment of the account balance when due, arrangements for a partial payment plan can be made with the Billing Manager.
Insufficient Funds Checks
Returned checks will be charged back to the patient's account. There will be an additional $25 service fee for each returned check. We reserve the right to require cash or credit card for future payment on accounts with frequently returned checks.
Missed Appointments
A missed appointment prevents our practice from providing care to other patients. Patients who have missed their appointments without notifying us will have a $35 fee applied to their account. Appointments must be canceled or rescheduled prior to 24 hours of the appointment in order to avoid incurring a fee.. Ap[point