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Insurance/Billing

pediatrics

Insurance and Billing Information

Do you have any questions regarding your insurance? Feel free to call us with any questions regarding your co-pays, deductibles, immunization costs, and PCP plans. It is important that you know exactly what is covered in your insurance before choosing a pediatrician for your child.

pediatrician
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Billing Information

Every time you come to the office, be sure to bring your most current insurance card. This will ensure accurate documentation. Please note that incorrect or out-of-date information will cause delays in processing and may cause you to be responsible for the full payment of the claim.

Billing Authorization

Payment Information

We ask that all balances (co-pays, deductibles, and self-pay fees) must be made at the time of service. Payments may be made with cash, check, and credit cards. Your payment is determined from your insurance card, which you must bring with you to each visit.

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Notification of Changes

It is important that you notify Nuga Pediatrics of Lenawee immediately of any changes to your insurance. We ask that you bring your new card to the office to enable us to accurately update our records. Likewise, any changes in your personal information, such as change of address or telephone number, should be made known as soon as possible.

Insurance We Accept

Nuga Pediatrics of Lenawee accepts several commercial insurances available in the area. Please, call our office before your appointment to confirm that we accept your insurance. Accepted insurance companies include, but are not limited to:

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Please note that your insurance policy is a contract between you and your insurance company. We encourage you to take time to understand your benefits as Nuga Pediatrics of Lenawee cannot guarantee payment of your claim. We will hold the patient responsible for any uncovered services.

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Insurance

YOUR INSURANCE IS A CONTRACT BETWEEN YOU AND YOUR INSURANCE COMPANY.

Parents/guardians are advised to thoroughly familiarize themselves with their insurance plan coverage and benefits. It is your responsibility to confirm with your insurance company that Dr. Adenuga is considered an In-Network participating provider. Our office accepts both in network and out of network patients. You MUST present an active Insurance card at every visit. We take an image of the card to facilitate filing the visit claim with the insurance company.

 

We are required by the insurance companies to validate insurance cards and coverage for every visit.

 

Secondary and Tertiary insurance information MUST be disclosed to our registration staff at the time of the visit.

 

All insurance companies have timely filing deadlines: Please provide our office with detailed and accurate insurance information to avoid being liable for the bill in full.

Patients without valid insurance cards on file will be categorized as "Self Pay”.

Patients with HMO plans must ensure that their profile with the insurance company lists Dr. Adenuga as their Primary Care Physician (PCP) on their profile in order to receive care.

 

Newborns have a 30 days grace period to ensure that Dr. Adenuga is added as the PCP.

Grace Period

We will allow a grace period of no more than 30 days from the date of service for our office to be furnished with complete and accurate insurance information. Thereafter claim will no longer be filed by our office and the patient will have to be personally responsible for payment.

 

NugaPeds will not be involved in disputes between patients and their insurance company regarding deductibles, co-payments, covered charges, secondary insurance other than to supply factual information as necessary. Any issues/disputes will need to be resolved independently with the insurance company.

 

Please be advised that you are initiating services to be rendered by our office (NugaPeds) ultimately you are financially responsible for all charges incurred whether paid by your insurance or not.

 

YOU ARE RESPONSIBLE FOR THE TIMELY PAYMENT OF YOUR ACCOUNT.

Missed Appointments

We are building a symbiotic relationship and we need to be mutually respectful of each other for the relationship to be cordial and efficient. As the Provider, we ensure that when you make an appointment that time is blocked just for you and your child. We expect that you will keep the appointment. As a courtesy to all our patients we attempt to confirm appointments a day in advance but ultimately you are responsible to mark your calendar to ensure that you to keep the appointment.

 

We do understand there could be uncontrollable circumstances when you are unable to keep a scheduled appointment. However, if this becomes a pattern for your family’s appointments, we reserve the right to terminate you as a patient.

 

We require a 24-hour notice when canceling or rescheduling appointments to avoid charges.

Last minute cancellations or reschedules (less than 2hours from appointment time) still result in lost appointment times as we are unable to utilize the slot for other patients.

Please help us to serve you better by keeping scheduled appointments.

 

Missed Appointment Fees:

The following are considered to be missed appointments:

  • A no-show appointment

  • An appointment canceled/rescheduled 2 hours or less to appointment time

 

Rechecks and sick visits - $35.00 

 

Well child visits, Complex check-ups or Consultation - $50.00

 

This fee is not covered by insurance! It is your personal responsibility and MUST be paid prior to next visit. 

Returned Checks

The administrative fee for ALL returned checks - $35.00.

Accounts with a history of returned checks will be marked as a “No Check Account”.

Payments on a “No Check Account” can only be made by CASH, MONEY ORDER, or CREDIT CARD.

We reserve the right to report any incidences of bad checks to the appropriate authority and take legal action.

Delinquent/ Past Due Accounts

  • Accounts that are more than 45 days overdue will be marked delinquent and turned over to in-house collections.

  • Accounts that are more than 60 days overdue will be turned over to an external collection agency.

 

Once a past due account is turned over to full collection  (external credit collection agency) our office will no longer have control or access to that account and you run the risk of having the incidence reported to a credit reporting agency.

 

All additional costs incurred by NugaPeds including but not limited to legal fees incurred when an account is turned over to full collections will be your responsibility.

Please help us keep costs down by paying all balances in a timely manner.

Personal Disputes/ Custody

As a policy NugaPeds and our staff NEVER get involved in family disputes of any type: custodial issues/disputes /financial issues or disputes between parents etc.

We will look to the custodial parent for reimbursement of any monies owed unless legal documents expressly state otherwise.

Please bring all necessary documents showing/court orders.

Other Miscellaneous NON-Covered Charges

  • FMLA forms $20 ( Allow 7 business days)

  • Immunization Records print out $5.00 ( 2 business days)

  • Immunization Records print out “Same Day RUSH” $10.00

  • School/sports/daycare/camp forms $10 - (2-5 business days) charge waived if presented at the time of well visit

  • School/sports/daycare/camp forms “RUSH” $30 – waived if presented at time of well-visit (Same day)

  • Medical Necessity/Legal Authorization Letters $20 (Allow 7 business days)

  • Medical Passport Form $20 ( Allow 7 business days)

  • Records transfer (rates vary depending on record volume and method of records transfer. Please call the office for rate)

 

Please complete every part of the form that needs to be completed by the parent before dropping off at our office. Partially completed forms or forms not completed will not be processed. Failure to complete forms properly will affect the turnaround time.

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