Practice Policies

Thank you for choosing Loudoun Pediatric Associates for the care of your children. We strive to provide the best services and quality care possible. We also strive to have the same level of quality when billing for our services. This guide will serve to assist in getting your services paid. It is your responsibility to be knowledgeable about your insurance. The patient responsibilities at each visit are:

  • A current insurance card
  • Your co-payment
  • Payment of any past unpaid balances

We are contracted with the majority of health insurance companies in the region, and will file with those plans as a courtesy to you. Eligibility is based on information you present and is confirmed prior to your visit. Our services are billed within 24 hours from time of the visit. After 30 business days you are expected to pay any unpaid balances regardless of your insurance company’s decision to deny coverage or to reimburse less than the allowable charge.

Patients who arrive to be seen in our office with invalid/terminated insurance, lack of proof of continuing coverage, or the wrong doctor’s name on the card will be seen if payment for the visit is received at the time of service. You also may elect to reschedule your visit.


We are no longer accepting new Medicaid patients as of August 1, 2011.

Updated Information

It is critical for us to have your current information for billing and, if necessary, for our office to contact you. Your insurance plan requires you to keep our office current on any changes in address, phone number or coverage. Parents should immediately contact their insurance plan to add their newborns to avoid paying out of pocket for services. Most insurance companies require this be done before your child is 30 days old.

Payments due at the time of service

Payments are always required at the time of service. These include applicable co-insurance, co-payments, and any outstanding account balances. Failure to pay co-payments at the time of service is a violation of your insurance contract and may be reported.

Additionally, since most patients we see are under the age of 18 years, we consider the parent or guardian who arranged for the appointment and/or accompanied the child as the responsible party and we will seek payment from that party. This practice is not a party to or bound by any court order that delineates financial obligations for medical care between a child’s parents. These orders only establish responsibilities for the parents.

Copies of Records

We are authorized by the Commonwealth of Virginia to charge a fee for copies of medical records. We charge $10 per child.  Please call the office to arrange copying. You may visit the “Forms” section of our website to download the Medical Records Release Form.


We are authorized by the Commonwealth of Virginia to charge fees for the time our healthcare providers spend filling out and verifying information for the various forms that your children need. We charge $10 per form.

Missed Appointments

If you need to cancel an appointment, we request that you give us at least 24 hours prior to the appointment in order for other patients to be scheduled in the time originally set aside for you. Failure to cancel in a timely manner will result in a $50 fee. This fee will be the responsibility of the patient and will be billed to the patient account. Should you fail to cancel two or more appointments, you may be discharged from the practice.

Collection Agency

Failure to pay balances may result in the account going to an outside collection agency. When you receive your monthly statement, please contact our billing department (703-443-6717). Your account representative will work closely with you if you need to establish a payment plan.


Please allow our office 72 hours to complete referrals. We do not fax referrals to specialists’ offices; they must be picked up in person.

After-Hours Phone Calls

We charge $10 per call for after-hours phone calls to our on-call provider. This charge is billed directly to your patient account and not your insurance company.