INSURANCE INFORMATION
We participate with the following insurances. Participation may change without notice. Call our office for a complete list of insurances.
Aetna
Blue Choice
Excellus BCBS
BCBS out of area Blue Card (We do not participate with BCBS Highmark WNY)
CHP (BS, Fidelis and Your Care only)
Cigna
Fidelis (Both Medicaid and Fidelis Commercial ins.)
Independent Health (PPO ONLY)
Lifetime Benefit Solutions
Medicaid
Molina
MVP (Commercial Only no MVP CHP, or MVP Option)
Tricare
Univera- PPO only (no HMO)
YourCare
It is your responsibility to know the coverage your plan offers, including which services require a co-pay or deductible.
Call your insurance carrier for answers to specific coverage questions.
Your insurance carrier must be notified when adding a new baby or adopted child to your policy. If required by insurance, the name of the pediatrician must also be added to the contract – effective on or before the child’s first visit at Long Pond Pediatrics. We need the insurance contract number to add to our system. If there is no insurance after 75 days from the date of birth of the child, outstanding balances will be your responsibility.
Patients with a non-participating insurance will be required to pay in full for all services at the time of service. We will provide you with the required information to submit your claim to your insurance for your personal reimbursement. If you have any questions regarding your coverage, please contact your insurance carrier for an explanation of your health care plan.
Our billing office number is 585-225-0950 x106.
Financial Policy
The goal of our administrative staff is to make sure that your claims are handled properly and that you have a complete understanding of your out-of-pocket medical expenses. Please look through the policy information below, and do not hesitate to call us if you have any questions. Again, Long Pond Pediatrics does not quote insurance benefits, but asks that you refer to your insurance carrier to understand the benefits/limitations of your policy. For your convenience, payments to Long Pond Pediatrics can be made by online bill pay, cash, check, Visa or Master Card, and can be paid via our pay now button, in person, by mail or telephone. Billing office phone # is 585-225-0950 x106.
We require that parents:
Present your insurance card at each visit or when requested.
Pay all copayment and/or deductible amounts (allowed by insurance) at the time of service.
Contact us with any changes of insurance information.
Contact us if having difficulty meeting financial obligations. We would be happy to discuss our payment plan options with you.
Sign a financial release, which includes the following:
- Insurance cards must be presented at each visit. All copayments must be paid at the time of service. Deductible plans will be collected at check-in at a set limit per the insurance coverage. Any additional charges for a deductible plan will be billed to the patient after the claims has been processed and paid by the insurance plan.
- If there is no payment made at the time of service, there will be a $25 billing fee added to the account. This billing fee will be waived if a payment is made with the billing department no later than 11:00 a.m. the following business day.
- Copayments/deductibles are expected to be paid by the person that accompanies the child to their visit, regardless of any other financial or legal arrangements. Compliance with court ordered arrangements will need to be discussed with the Billing Department ahead of the visit. We will be happy to provide a proof of payment if necessary.
- Well child exams may include an extended exam of a current diagnosis, or treatment of a separate illness or injury. The provider may bill my insurance for additional charges that may incur additional copays and/or deductibles. A list of examples of these extended services is posted in each exam room.
- A minimum 24 hour notice is required when canceling an appointment. Failure to provide adequate notice will result in a $100 fee.
- Appointments scheduled on the same day require a minimum of 2 hours’ notice if cancelling to avoid possible service fees.
- Failure to show for any appointment will result in a $100 service fee. This is not billed to your insurance and is your responsibility. Please note repeated no-shows or cancellations may result in being discharged from the practice.
- Long Pond Pediatrics will align their form request policy with Federal and State guidelines. Forms, including PFL, FMLA, day care and camp will be completed within 5 business days. There is a $10 service charge collected at the time of request. Forms needed sooner than 5 business days will incur an additional $10 service charge.
- Checks returned for insufficient funds will incur a service charge of $30 plus bank fees.
- Lab work sent to an outside agency may incur additional charges that is billed separately by that agency.
*An important message to parents in a custodial, non-custodial or shared parent arrangement*
As is common practice in pediatric offices, out-of-pocket expenses will be collected at the time of service from the parent or guardian who brings the child to their visit, regardless of any other financial/legal agreements dictating who will pay. Bills for outstanding claims will be mailed to the address where the child resides.
Compliance with court ordered arrangements would take place between the involved parties. LPPG does not enter into those arrangements. Any additional issues regarding financial responsibility should be addressed through Family Court Services.