We participate with the following insurances. Participation may change without notice. Call our office for a complete list of insurances.
Aetna
Excellus BCBS (Except Western NY and Highmark)
Cigna
Fidelis (Both Medicaid and Fidelis Commercial ins.)
Medicaid
MVP
Tricare/Humana
Meritain
Participating but not accepting new patients:
Molina
Univera
Independent Health
United Health Care
MVA
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. 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. Payments can be made by online bill pay, cash, check, Visa or Master Card (4% processing fee), 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:
· A valid insurance card must be presented at each visit. The policyholder is responsible for providing complete and active insurance information. If this information is not provided, services will be billed as self-pay at the time of the appointment.
· All copays, deductibles, and outstanding balances are due at the time of service. Payment is expected from the individual accompanying the child to the appointment, regardless of any other financial or legal arrangements.
· Well-child exams may also include an extended evaluation of an existing condition or treatment for a separate diagnosis, illness or injury. Providers are required to bill based on the services rendered, which may result in additional copays and/or deductibles. Examples of these extended services are posted in each exam room.
*** Patient statements for outstanding balances will be sent either by mail or through the patient portal. Balances are expected to be paid upon receipt of the statement. Accounts that remain delinquent may be subject to collection action and could result in dismissal from the practice. If special circumstances prevent immediate payment, payment plans may be arranged with the billing department.
All patients are subject to the following policies, regardless of insurance type:
· Co-payments and deductibles not paid at the time of service will incur a service fee that will be added to your account.
· A minimum 24-hour notice is required when canceling or rescheduling an appointment. Failure to provide this notice will result in a service fee.
· Failure to show for any appointment will result in a service fee. This is not billed to your insurance and is your responsibility. Multiple no-shows and/or same day cancellations may result in being discharged from the practice.
· Long Pond Pediatrics aligns 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 service charge collected at the time of request. Forms needed sooner than 5 business days will incur an additional service charge.
· We accept Visa and Mastercard. A 4% processing fee will be applied to all credit card transactions. Patients who wish to avoid this fee may pay by cash, check (payable to Long Pond Pediatrics), or HSA. By signing below, you acknowledge that you have been informed of this surcharge and agree to its application when choosing to pay by credit card.
· Checks returned for insufficient funds will incur a service charge plus bank fees.
* 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.