Financial Policy

Thank you for choosing Warren Pediatric Associates as your health care provider.  We are committed to providing the best possible care and service for your children.  We regard your understanding of our financial policies as an essential element of your child's care and treatment.  If you have questions about your account, charges, insurance or payments, please contact our office at 814-723-8023. 

INSURANCE

Your insurance policy is a contract between you and your insurance company.   We have contractual obligations with several PPO (preferred provider) and HMO (health maintenance) plans and will inform you if we participate with your insurance plan.  As part of this contract, we are required to collect all co-pays, deductibles, and balances.  Not every insurance company will cover all the services that we perform.  This office does not always know what different insurance companies will pay.  We will file insurance claims according to our agreement with the participating insurance plan if you provide us completed financial information forms and a copy of the insurance card for each covered member of the family.  We must receive the information within 30 days of the initial visit.  All charges will become your personal responsibility if completed insurance information is not provided or if eligibility cannot be determined.  By signing our financial statement, you are agreeing to pay for all coinsurance, deductibles, co-pays and non-covered charges that your insurance company deems are your financial responsibility. 

If you change insurance companies, it is your responsibility to inform our staff.  If you fail to do so and we file the claim with the wrong company, you could be responsible for the entire fee if the claim surpasses the filing deadline with the correct company.  If your insurance company does not pay the bill after repeated attempts by this office to file and obtain payment, the unpaid balance will become your responsibility.  If you are able to get the insurance to pay, you will be promptly refunded any amount due to you.

We participate with some major insurance companies such as Highmark Blue Shield, Pennsylvania Medicaid, AmeriHealth Caritas, Cigna, Gateway, Health America, UPMC, UPMC for You, UPMC for Kids, United Healthcare, and for some selected HMO, POS, and PPO Programs; however, you will still be responsible for payment of any co-payment, deductible, coinsurance, or non-covered services such as the office visit.

If you do not have insurance, the office visit charge is due at the time of the visit.  If necessary, other procedures done in the office may be paid in monthly installments.

If both parents have insurance, the parent with the first birthday in the year is most often the primary insurer.  Please check your insurance policy to determine which company is primary before your appointment.  In divorce cases, we will bill the insurance requested, but the parent who brings the child in for services is ultimately the responsible party.

BILLING

A billing statement covering medical servies rec1eived will be mailed to you on a monthly basis.  If you have a financial problem, please ask to discuss a payment plan with our billing department.  If a budget payment plan has been offered to you, we require regular monthly payments or the plan is void.  After that, the account may be turned over to our collection agency.  You then will be responsible for any collection costs.  We accept cash, checks, Visa and Master Card.  In the event a personal check is returned unpaid from your bank for any reason, your account will be charged with a $30.00 return check fee.

URGENT AND/OR AFTER HOURS VISITS AND HOLIDAYS

There may be additional fees for urgent and/or after hours visits and when we are open on holidays. 

COLLECTION BALANCES

If you had a previous collection balance or are presently in collection, the physician may use his discretion as to seeing you again.  It may be required that you pay your previous balance prior to being seen.  You will be responsible for payment of the office visits, co-payment, deductible, etc., on the day of the visit.

Our financial policy is subject to change without notice and your signature on the office policy form presumes that you have read and understand these policies.