Billing and Insurance Policy

We strive to meet all the requirements of all insurance companies so that our families never have to change providers if they have an insurance change.  Please check with your insurance company before each visit to be sure your visit will be covered here.  If not, please let us know and we will do what we can to be able to accept that insurance.

Patient Centered Medical Home

A common-sense concept has emerged in the medical community called the Patient Centered Medical Home. A “Medical Home” is a home base in which a healthcare team and family work together to meet a child’s healthcare needs. Below we have outlined the responsibilities we expect Liberty Pediatrics staff and families to assume in order to provide the best possible care.

Healthcare Provider’s Responsibilities

Non-discrimination: We are committed to providing care without bias based on socioeconomic class, race, ethnicity, sexual orientation, gender expression, age, religion, or physical difference/ability.

Fairness:  We bill equally for all of our services, including well visits, sick visits, nurse calls, social worker and other mental health visits, and dietician visits.  

****We are legally required to equally charge all patients for services, whether or not they have insurance coverage for that given service.

We are not legally allowed to charge insurance companies for a given medical service  then not charge individuals who don’t have coverage for that service.  If we know, however, that you will self-pay for something, we are allowed, and do, provide a self-pay discount.  Please let us know in advance of any service that you will pay out of pocket for that service, and we will apply the self-pay discount.

Communication: We listen to our families to help them make decisions about their care. Our providers aim to explain diseases, treatments, and results in an easy-to-understand way. Our goal is to end every visit with clear instructions about expectations, treatment goals, and future plans.

Privacy: We will keep treatments, discussions, and records private.

Access: There is 24-hour access to medical care with an after-hours triage service and rotating on-call doctors. We offer same day appointments for sick visits when deemed medically appropriate, and also provide instructions on how to meet your child’s healthcare needs when our office is not open.

Records:  All families may access our patient portal from our website.  At age 16, all family members other than the teen are restricted from accesss to the portal except for billing and scheduling.  Complete medical records are available at no cost within 15 business days of a request.

Patient Responsibilities

Timeliness: We try our very best to run on time for all appointments and therefore ask that you arrive five minutes before your scheduled appointment time and let us know if you will be late. If you are 10 minutes late for an appointment, we may ask you to reschedule or wait for the next available provider. We also have a same day cancellation and missed appointment fee of $20 per appointment.

Well Child Care: Well Child Visits are crucial for positive relationship building and informed medical decision making. These visits give us a baseline of health for our patients and enable us to monitor physical and developmental growth. Upon the passing of the Affordable Care Act, all major insurance plans sold after 2014 are required to cover in-network Well Child Visits; if your pre-ACA policy does not cover these visits, we are happy to work with families in order to provide this important care.

Financial Accountability: We try to credential our practitioners with as many insurance plans as possible. Because of the large number of plans we do accept, it is impossible for our office to be familiar with the intricacies of every patient’s policy; rather, this is the policy holder’s responsibility. This responsibility includes, but is not limited to, financial accountability for copays upon time of service, fees applicable to deductible plans, and any amount not paid by insurance. However, we never want patients to avoid medical services because of cost and will arrange payment plans as necessary.  It is also very important that you let us know during check in if you have new insurance, and that you report to your insurance company as soon as you establish care with us that we are your primary care provider.  Finally, every year most insurance companies require you to fill out a form called Coordination of Benefits, in which you report to them any other insurance coverage you have, including telling them that you have no other coverage. 

Scope of Practice:  We believe part of providing holistic care to families includes the opportunity to have visits with our social worker, our mental health nurse, and our dietician.  Because insurance companies do not always pay for those services, we do require you to sign a billing agreement before engaging with those providers.