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Billing & Insurance




 

Billing & Insurance Information

 

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.

 

We do have a few rules in place:

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 $75 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 $75 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. 

Any bill sent through traditional mail will be assessed a postage and handling fee of $1.

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 payment, 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).

Failure to show for an appointment without prior notification may be billed as follows: $75 for the second occurrence and $75, with possible discharge from care, for the third occurrence.

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

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.

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

Lake Country Pediatrics S.C. is a fiscally and environmentally responsible organization. As such, we are in the process of going 'greener.' (We are no longer sending out paper statements, as they are redundant to the Explanation of Benefits your insurance sent detailing what was paid/adjusted and what you owe.) We would appreciate your help by giving us your e-mail address. We then can send your statements, receipts, and other information to you via your e-mail.  We make courtesy calls to inform you of any balances outstanding approximately one week after the statements have been sent. Feel free to inquire about your account at any time, either in the office or by phone.

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