Billing & Insurance Information

Guidance, advice, and information from our friendly billing team.

Working with Your Insurance Company

Lake Country Pediatrics S.C. understands that billing and insurance is not straightforward and can sometimes be downright confusing. Our goal is to provide a professional, friendly, helpful and informative billing service to you.

We bill your insurance company as a service to you. If you receive a bill from us it is because your insurance has made a determination that the services are being applied to your deductible or coinsurance. If you believe this to be in error, please call for advice. We will work our hardest to access the benefits that you deserve from your insurance company.

Our Billing and Insurance Policies

At Lake Country Pediatrics, we have a series of policies in place to help our billing and insurance team as they work to process your claims and payments. Please select a topic below to get more information:

Co-Pays

Co-pays are due at time of service. These are set by your insurance company and we are required to collect them by direction of our contract with your insurance company – we cannot waive them. If we have to send you a bill for unpaid co-pay, a $10 billing fee will be added.

If you have not met your deductible, we require that you pay $100 at the time of service. If we bill your insurance, and receive full payment, we can apply a credit to your account or issue reimbursement at your request. Should the $100 not cover the complete amount, you will be billed for the balance.

For families with high deductibles – if you pay the bill for services IN FULL at the time of service, we offer a 10 percent discount.

Once Lake Country Pediatrics, S.C. receives an Explanation of Benefits (EOBs) on your bill, we will bill the balance to you either through email or traditional mail.

Paying Your Bill

For families with high deductibles – if you pay the bill for services IN FULL at the time of service, we offer a 10 percent discount.

Once Lake Country Pediatrics, S.C. receives an Explanation of Benefits (EOBs) on your bill, we will bill the balance to you either through email or traditional mail.

Any bill sent through traditional mail will be assessed a postage and handling fee of $5.

Payment Due Dates & Late Fees

We will call you approximately one week after your bill has been sent out. This is a service to you to allow you to pay the balance over the phone. If you prefer to mail in a check or make a payment online, please let us know when we call.

If we have not received payment after two bills have been sent and two phone calls made, you will receive an invitation in the mail to pay your balance or make payment plan arrangements. If the invitation does not result in a response, your bill will be sent to a collection agency.

Accounts greater than 60 days of age past your insurance determination will be referred to an outside agency for recovery. Any amount out to collections totaling $75 or less is due in full prior to your child being seen. For any amount out to collections greater than $75, a payment of $75 must be made at each visit, prior to your child being seen, until the balance is paid in full. Any co-pay and/or deductible deposit is also due at the time of service. In addition, Lake Country Pediatrics, S.C. reserves the right to add an additional collection fee or attorney fee if your account is sent to collection (fee not to exceed 35% of balance for collection and 50% of balance for attorney fees).

There will be a finance charge of 17 percent applied to accounts 60 days or more overdue.

No Call/No Show Fees

Failure to show for an appointment without prior notification may be billed as follows: $40 for the first occurrence, $100 for the second occurrence, and $100 with possible discharge from care, for the third occurrence.

Non-Sufficient Funds

For NSF checks there is a $50 charge in addition to the amount of the check.

Families with No Insurance

For families with no insurance, we will offer a discount at time of service. This amount must be paid prior to your child being seen. Please call to discuss available discounts.

Billing Department Communication

If you are interested in getting e-mails from our billing department, call 262-567-5366, or visit our Contact page to send the billing department a message.

Accepted Insurance Providers

Golden Rule
Great West
Health Payment Systems
Humana
Medica
Principal Life
Principal Mutual
Tricare

Trilogy
UMR
United Healthcare
Unity (including state employees w/Unity)
WEA
WPS

The list above may not reflect our full list of accepted providers. If your insurance is not listed, please contact our billing department. They will verify if we can accept your insurance provider or reach out to begin the process of joining your coverage network.

Badgercare/EDS/ForwardPortal/State Insurance:

Molina/Molina
Children’s Community Health Plan
Community Connect
Managed Health Services
Network Health
T19 (Straight EDS)

3rd Party Pricers:

Health EOS by Multiplan

If you have any questions, please call 262-567-5366, or visit our contact page to send the billing department a detailed message.

Nominated and Awarded
Most Loved Pediatrician!

Dr. Moyer clinched the 1st place Top Pediatrician in Lake Country, Dr. Schilz made his mark in the top ten, and Dr. Kolp-Jurss made a stellar appearance in the top 15 – it’s a powerhouse of exceptional dedication!