Billing & Insurance
Insurance
We accept most insurance carriers.
Please have your card with you at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.
Billing
As you may be aware, Federal law mandates that insurance companies cover all doctor visits for preventive (well) services at 100%. This means that no payment is due from you as long as the preventive portion of the care given to your child is usual, customary and reasonable with respect to parental concerns and time involved.
However, during well child visit, a parent may have additional concerns regarding a potential medical illness or condition. Likewise, the physician may find an abnormality that requires further investigation. Please understand that, in this case, the doctor must code not only the preventive service, but also any another procedure performed as well as all additional diagnosis your child may have. This may be an ear infection, poor weight gain, rash, behavior problems, etc.
Physicians are required to code all diagnosis observed in every visit including the well visit. Depending upon the diagnosis and other factors, the physician is required to submit to your insurance company a well and sick procedure code together for the same date of service. This will generally result in a co-pay or cost-share for the sick diagnosis portion of the visit.
In the interest of conserving your time, energy and efforts, Lynchburg Pediatrics will continue to offer comprehensive medical services at each well visit and WILL NOT require you to schedule an additional office visit to evaluate these sick diagnosis observed during the well visit.Your insurance will process the sick visit according to your benefits.
This may result in a co-payment or the visit may be applied to your deductible, both of which are your responsibility. Co-payment and deductibles for the additional diagnosis will not be collected at the time of the visit so we can determine how the insurance company defines your benefits. You may, at a later date, receive a statement in the mail for any additional payments required for this additional office visit if it is not covered in full by your insurance company.
