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.
Medicaid
We are not accepting new Medicaid patients as of February 2020.
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. We will not be able to bill the patient for co-payments.
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.
Forms
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/Late Arrival Policy
No-Show Fees:
We understand that unforeseen circumstances can sometimes happen. If you find that you are unable to come for your child’s scheduled appointment(s), we ask that you contact the office to cancel your appointment no later than 24 hours prior to your appointment time. If you do not cancel your appointment within 24 hours or do not come in for your appointment without notice, the following no-show fees will apply:
Sick visits: $50
Physicals/30-minute consultations: $100
Consultations that are 1-hour or more: $150
Lactation Appointments: $75
This fee(s) 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.
Same-Day Sick Appointment Cancellations:
Parents who schedule a same-day sick visit will have a 2-hour courtesy window to call back and cancel their same day sick appointment without incurring a no-show fee. Cancellations past the 2-hour window or no-shows will be charged the $50 sick appointment no-show fee.
Late Arrival Policy:
Physicals/Well-Child Visits/Consultations:
As there are usually paperwork and forms involved with these visits, we ask that all parents/patients arrive 15 minutes prior to their appointment time. Patients who arrive late for their appointment will unfortunately have to be rescheduled so that our other patients can be allotted the appropriate time for their visits.
For families who are coming in with more than one child, we ask that you arrive at the office 15 minutes prior to your children’s appointment to ensure that each child is given the appropriate amount of time for their visit. Arriving late for your appointment will result in us only being able to see one child during this visit.
Sick Appointments:
If patients arrive late for their sick visit appointments, we unfortunately have to reschedule your sick visit (for later in the day or the following day), or refer you to urgent care, depending on your child’s reason for the visit/symptoms. If you are going to be late for your sick appointment, we ask that you call the office beforehand so that we can reschedule you or determine the next steps for your child’s care.
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.
Referrals
Please allow our office 72 hours to complete referrals. We do not fax referrals to specialists’ offices; they must be picked up in person. Please ensure that you have confirmation of your referral from our office before making your specialist appointment as we are unable to back-date referrals.
After-Hours Phone Calls
We charge $25 per call for using the nurse triage service after midnight (12 AM) Monday-Friday, and after 10 PM on Saturday-Sunday. This charge is billed directly to your patient account and not your insurance company.
Photos and Video Policy
Taking pictures or recording video is prohibited in the office treatment areas.