Sunday, 04 May 2008 12:23
Business Office Policies
Thank you for choosing Bay Area Pediatrics as your children's medical provider. In order to make the financial part of our relationship work most effectively; we would like to make you aware of our business office policies and procedures.
Business Office telephone number: 650-994-1800
Business Office hours: Monday through Friday 7:00AM-4:00PM
Business Office Address: 1500 Southgate Suite 213
Daly City, CA. 94015
HMO Patients: Please have your HMO membership card with you when you come to the office. HMOs require that we collect the copayment at the time of service, so we ask you to be prepared. We accept checks and credit cards as well as cash. Most services that we provide in our office are covered under HMO plans. There are some services that may not covered such as yearly school and/or sports physicals ( Most HMOs cover a complete physical exam every two years after the age of six). We will make every effort to let you know in advance of the appointment if we think a service may not be covered, but is it ultimately your responsibility to know the extent of your policy's benefits.
PPO/EPO Patients: Most PPO plans also require a copayment. Again please be prepared to pay the copayment at the time of service. We will bill your insurance for you. If your plan has a yearly deductible, you will be billed by us until your insurance company informs us that you have met your deductible. As with HMOs there are some services which we provide that are not covered benefits. We will attempt to bill on your behalf for all services, but you will be responsible for services that are not covered.
Health Plan of San Mateo/MediCal: Please bring your child's MediCal ID card with you to all visits. We use the card to determine your child's eligibility for that month. If we cannot verify your child's eligibility, then you will be responsible financially for that visit.
Cancellations: Please call us to cancel appointments at least two hours before the scheduled appointment time. This will allow us enough time to schedule another patient who may need urgent care visit. No shows may be subject to a $40.00 charge.
Lab, X-Ray, Emergency Room and Urgent Care: Most Health Plans have specific contracted facilities for these services. In most cases we will be able direct you to the appropriate facility for your Plan. However it is ultimately your responsibility to be aware of your plan's contracted facilities and to use them appropriately.
Referrals: For all HMOs and some PPOs prior authorization is required for specialty services. The length of time required to obtain authorization varies depending on the urgency of the problem and the specific policies of the Heath Plan and/or Medical Group. Please do not make appointments with specialists before you have written authorization. If you see a specialist without authorization, you may be required to pay for the visit. Retroactive authorization can be obtained in emergency situations, but are nearly impossible to get for routine matters.
Records Releases: We will be happy to provide upon request, a summary of your child's medical record to you or to your new pediatrician at no charge. If you require a complete copy of the medical record, there will be a $20.00 charge to cover our costs. Please attach a check with the completed medical record release form. Release forms are available at any Bay Area Pediatric Medical Group office site.
This e-mail address is being protected from spambots, you need JavaScript enabled to view it Please contact Donna O'Connell, our Billing Office Manager.