FINANCIAL POLICY

Thank you for choosing Sierra Pediatrics. In order to better serve our patients we have the following financial policies. Please be prepared for Sierra Pediatrics to make a copy of your driver’s license and your child’s insurance card at every visit.  Sierra Pediatrics, Dr. Colombo or Dr. Frazee must be listed as your child’s Primary Care Physician if required by your insurance company.  If you do not have Sierra Pediatrics, Dr. Colombo or Dr. Frazee listed as the Primary Care Physician please contact your insurance company prior to your appointment to have this changed.  Sierra Pediatrics reserves the right to change this financial policy at any time.  A current financial policy will always be available upon request.

Fees:
Your health insurance policy is a contract between you and your insurance company. Thus, please remember that the patient, parent, or legal guardian is ultimately responsible for all charges incurred. Co-pays must be paid before seeing the doctor.  If you have a co-insurance, an annual deductible and it has not been met, or you are a self pay patient please be prepared to pay the amount due at the time of service. In addition, if your child has an account balance, 50% must be paid plus any co-pay before seeing the doctor. Sierra Pediatrics reserves the right to charge $30 for appointment day cancellations or no-show appointments. All missed appointment fees must be paid in full before your next appointment.

Billing:
As a courtesy to you, Sierra Pediatrics will submit insurance claims.  However, we do not accept third party payors, or Medicaid as a secondary insurance. If your child is covered by more than one insurance policy please read the section on secondary insurance.

Any charges not covered by your insurance company will be your responsibility.  Payment is due upon receipt of your statement.  We understand that situations may arise which may make it difficult to make payments on your account.  Please contact the billing office to make arrangements for payment.  Should your account become delinquent and sent to a third party collection agency, Sierra Pediatrics will immediately relinquish the care of your child without further notice.

Forms of Payment:
For your convenience, Sierra Pediatrics accepts cash, local checks, Visa, Master Card, and Discover Card.  We are unable to accept or make change for $50 or $100 bills.  There will be a $30 charge for all checks returned for insufficient funds, and checks will not be accepted for future visits. .  All credit cards/debit cards are transmitted through the internet.

Online Bill Pay - You can now pay your balance any time of day through our internet payment agent, Navicure.  All patients who have a balance of $150 or higher and cannot pay in full, need to sign –up for a payment plan through Navicure and maintain a credit card/debit card on file.  Navicure will truncate your account number for your security. Patients on payment plans will receive an email reminder that your credit card will be charged each month. 

Secondary Insurance:
In order to alleviate confusion and to ensure each insurance payor will reimburse at the correct rate, we require the following documentation before submitting claims, where a child is covered under more than one insurance policy.

Our office must be informed at time of service that there are two insurances for your child.  Please provide a written note outlining the health plan name and policy number, the subscriber name and birthday. We also require documentation from each insurance company that states the effective date, and their benefit plan payment order.

Birthday Rule - Most insurance companies use the birthday rule to determine which insurance policy is primary and which is secondary.  Under the birthday rule, the health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan.  Note that it doesn’t matter which parent is older, because the year of birth is not a factor, unless both subscribers have the same month and day of birth.  For example, if your birthday is June 1, 1985 and your spouse’s is October 25, 1980, your insurance plan would be considered primary because your birthday comes first in the calendar year.

Exceptions to the birthday rule include Tricare and Medicaid.  These insurances are always considered secondary.  Court orders can also override the birthday rule and the insurance companies and our office should be notified.

Why do I owe money when I have secondary insurance? Secondary insurance does not always cover the copay or deductible of the primary insurance.  We recommend that you contact your secondary insurance company for an explanation for your specific situation.

Vaccines:
Sierra Pediatrics believes one of the most important things parents can do to protect their children is to make sure they are vaccinated against serious but preventable diseases.

Parents or guardians are encouraged to check their benefit booklet for coverage information or to call their insurance company.  Some insurance policies may have deductibles, coinsurance and/or co-payments for vaccinations.  We encourage you to call your insurance and ask the following questions:

  • Do I have insurance that covers immunizations?
  • Does my insurance cover Nevada state required immunizations?
  • Are there any coverage limitations or restrictions such as age limitations on covered vaccines or coverage with wellness exam only?
  • Will I have to pay anything for immunizations such as co-pay, co-insurance or deductible?
  • Is there a maximum amount my insurance will cover each year for wellness services, preventative services or immunizations

Vaccines for Children (VFC):
Vaccines for Children (VFC) immunizations are supplied by the Federal Government.  Patients eligible for VFC vaccines are as follows:

  • Medicaid recipient
  • No health insurance
  • Under insured
  • Native American or Alaska

If you qualify for VFC vaccines please let our office know so that we can update your child’s account.