While our number one priority is to serve the healthcare needs of our patients and their families, we must also make you aware of our financial policies. These policies are designed to help you avoid improper charges and ensure the viability of the practice as well as adhere to the regulatory environment.
It is the guarantor’s (responsible party) responsibility to present accurate and current insurance information. We request that you bring both primary and secondary insurance to each visit for review and/or update into our billing system. Providing this information will allow us to appropriately bill your claim for services and alleviate greater financial responsibility for you. It is your responsibility to keep us updated about your information when changes occur throughout the year. Any charges that may occur due to your failure to provide us with current information will become your responsibility to pay.
If you fail to bring current insurance information the services will be considered self-pay. You will therefore be asked to pay for the service on the day of the service. We accept cash, checks, and Visa and MasterCard credit and debit cards. We do not accept American Express.
It is your responsibility to understand the insurance companies with which we have contracts. If we do not have contracts with your insurance company you may be subject to out of network benefits which will result in higher co-payments, deductibles or non-covered care.
In addition, it is also your responsibility to understand your healthcare benefits with your insurance carrier. Please understand that there may be co-payment, deductible, and co-insurance requirements. Furthermore, your policy may not cover all services provided by our practice. As such, you may be asked to sign a financial waiver that indicates that you will take financial responsiblity for services provided if yoru sinsurance company does not cover the service.
Zahra Pediatrics is currently contracted with the following insurance carriers. Each carrier has several plan options. Please confirm with our staff if we participate with your particular plan.
Health Networks we currently participate with are:
- Amerihealth Administrators
- Blue Cross Highmark
- Blue Cross of NEPA (First Priority Health, First Priority Life)
- Blue Cross Blue Shield Out of Area (except HMO plans)
- GWH Cigna
- Health America, 1st Health Network
- Medical Assistance Plans:
- Amerihealth Mercy and Amerihealth Northeast(Medical Assistance)
- Geisinger Family Plan (Medical Assistance)
- DPW Access
- *We do not accept the Medicaid or Chips plans for Aetna Better Health or United Healthcare Community Plans
- United Healthcare
• Intergroup (Must be on list check with our biller)
• Multiple Plan/PHCS (Must have name and logo on insurance card)
Zahra Pediatrics Financial Policy
We regard your understanding of our financial policies as an essential element of the care we provide for your children. To help us, please bring your insurance card at every visit and show it to the receptionist to avoid being billed incorrectly.
Coverage of Benefits
We try our best to help our families stay up -to-date and aware of insurance benefits . However it is your responsibility to know what coverage your insurance provides. It is impossible for our staff to know the details of well over 100 plans.
Some questions you may want to ask your insurance company are:
• Is Zahra Pediatrics a participating provider or is it our of network ?
• Are well-visits covered?
• Are vaccinations covered?
• Do I have a deductible? If so, how much?
• What lab can I use?
Payment is due at the time of service. We accept cash, check , Visa, Mastercard , and Discover. A receipt will be given for all payments.. We recommend that you keep all payment receipts.
Co-pays are collected during the check-in process. Any co-pay not paid at the time of service is charged a $10 service fee. Co-insurance, deductibles, and non-covered items are insureds/patients financial responsibility. If you receive more than one type of service on the same day (I.e. well visit and sick visit) you may be responsible for more than one co-pay.
Self-Pay patients/No insurance
We offer a 15% discount on all services for those without without health insurance. An additional 15% discount may be obtained if the balance is paid in full at the time of service.
Families will be asked to keep their accounts current at all times. If a balance is due on the family account for which a statement has been mailed, we will request payment at the time of visit. Payment arrangements can be made on any family balance of more than $200.
Motor Accident Visit
Please inform the staff if your visit is due to a motor vehicle accident. Please provide your auto insurance information and as a courtesy, we will bill for you. (See Motor Vehicle Accident form under Patient Forms.)
Refunds are issued to the appropriate party. Patient refunds will not be processed untill all active and past due charges are paid in full. Refunds less than $10 will be credited to your account.
We submit claims to many participating insurance companies. Any outstanding charges deemed as patient responsibility will be billed to you. If payment is not received within 30 days of a billing statement, a $10 service charge will be added for each additional statement.
Our billing department makes every effort to contact the responsible party to help them make payment in a convenient and responsible manner. If there is any difficulty with payment , please talk to our billing supervisor so that we may work with you.
We are not a credit agency and therefor cannot carry your debt to our practice. If payment is not made in a timely manner, our collection process will go into effect and we will no longer be able to schedule well care visits for your child.
Any unpaid balance after 60 days of the date of service may be referred to an outside collection agency. Accounts referred to a collection agency will be subject to an additional fee of 30% of the total balance due. This will impact your credit rating.