Frequent Billing and Insurance Q&A

 

When it comes to with dealing with insurance companies, we understand there are many questions regarding billing.  We have listed some answers to help with some common questions.  If you need further assistance, please call our billing department at 317-293-7177 ext 227.

 

Q:  If I owe a balance on my bill, how can I pay it?

A:  If paying in our office, we accept cash, check, and most credit cards.  We also have a convenient secure site to pay online at www.indygateway.net/indypeds/

 

Q:  I paid my office copay but now I’m getting billed?  Why?

A:  There could be several reasons why your insurance carrier didn’t pay in full.  Sometimes carriers will apply a balance towards a yearly deductable and sometimes they apply a percentage towards coinsurance.  These charges are in addition to your office copayment.   Every insurance plan is set up differently and from year-to-year things change.  It’s best to contact your insurance carrier, employer, or your agent prior to services being rendered to know what is covered and what your out of pocket cost might be.

 

Q:  Why would I receive a statement that should have been covered in full by my insurance?

A:   Please contact your insurance company by phone or review online if you believe the claim was not processed correctly.  Many times you will receive notice by your insurance company before we do.  The EOB (Explanation of Benefits) is often available online to you before we have it available to us.  The EOB will explain how the claim was processed and paid.  This will also give an explanation for charges they consider patient responsibility. 

 

Q:  Will I get separate bills for each child?

A:  Every patient has his or her own account number in our computer system but you should receive only one statement per month.  If you receive multiple statements, please contact our business office.

 

Q:  If I have 2 insurance companies, how do you determine which gets billed first?

A:  Every insurance company follows the birthday rule. The parent whose birthday is first in the calendar year is considered “primary” for insurance purposes.

 

Q: Will you bill more than 1 insurance carrier?

A:  Yes, make sure to bring all insurance cards to every appointment.  This will allow us to make sure all your information is current and up-to-date in our system.

 

Q: What Medicaid brands can your doctors see?

A:  We service both Indiana Medicaid Traditional and Managed Health Systems (MHS) and MHS Hoosier Care Connect.  If you currently are not registered under either of these plans and want to be seen at our practice, please contact your caseworker.  If you have MHS, your child must be assigned to either Dr. Daniel Hayford or Dr. Shana Zwick in order for us to see them.  If requested, your caseworker at MHS should be able to assign you to one of our physician panels.  If you have any further questions, please contact our office to discuss.

 

Q: How do I know if Dr. Hayford or Dr. Zwick is covered under my insurance plan?

A:  We are contracted with many insurance companies but the best way to know for sure is to contact them directly via telephone or by looking your insurance plan up online. 

 

Q. Can I be charged for an office and a preventative/well care visit on the same day?

A:  Patients should be aware more than one visit can be charge on the same date of service with the physician.  For example, if you are in for your annual physical examination and other problems are addressed or treated, an additional office visit fee may be charged.

 

Q. My child just turned 18 years old and still covered under my healthcare plan.  What happens now?   

A:  Adult children 18 years and older can still be covered under their parents healthcare plan.  In most cases, at age 18, they are considered a legal adult and are in charge of their own medical records and bills.  The next visit, on or after the 18th birthday, a new patient registration form will be required.  In addition to updating these forms, access to medical information about your adult child is limited.  This is due to the laws regarding the HIPAA privacy rules. 

 

 

 

 

 

 

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