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Services Provided: |
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PAYMENT CLINIC: Payment is due at the time service is rendered. We are prepared to accept cash, check, MasterCard, or Visa. If your child is covered by a managed care plan with which we participate, we will collect your clinic co-payment.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SURGERY: If the surgeon recommends surgery, our billing department will be happy to file a claim for surgical fees directly with your insurance company using the information which you provide on the Clinic Face Sheet and on your insurance card copy. Accordingly, please check with your plan to learn if special authorizations are required before hospitalizations or surgery. Our billing department will be happy to help you with any special insurance requirements. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * GENERAL: Your payment for the balance will be required after insurance benefits have been applied if those benefits are paid in a timely manner. Should your insurance company fail to make payment within 60 days of the time that the claim is submitted, you will be billed for the entire balance and collect your insurance benefits directly from the carrier. To avoid this situation, please consult your carrier if you are not notified of their payment within a reasonable amount of time. (By law, insurance must pay or deny a claim within 30 working days of claim submission.) ADDITIONAL INFORMATION COURTESY: As a courtesy we accept insurance as a method of payment; however, insurance should not be considered a substitute for total payment. It is ultimately your responsibility to pay any deductible amount, co-insurance, cost-share, non-covfered, allowed, or any other balance not paid by your insurance plan. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * BILLING: If your child is covered by a managed care plan (HMO, PPO, MCO, etc.) with which we participate, you will be billed for appropriate balances only after insurance has paid and informed us of your financial responsibility by contract. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * PERSONAL FINANCIAL SITUATIONS: If you are aware of a financial situation that will delay full payment of your account balance, we encourage you to contact our office as soon as possible. If your child is not currently insured, please discuss this with the scheduling secretary when surgery is planned. The Department of Pediatric Surgery at Vanderbilt Children's Hospital is responsible for providing timely care for many children with serious and often urgent problems. Late cancellations and/or missed appointments adversely affect our ability to provide needed care for our patients. It is extremely important to keep your appointment and to be on time. Failure to call our office 24 hours prior to your scheduled appointment could deny another seriously ill child an earlier appointment. We understand that circumstances beyond your control may arise, causing you to miss your appointment. However, you should be aware of the following consequences for not showing for your appointment without at least 24 hours of notice:
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Referral: If your insurance provider requires a referral in order to authorize payment for the services of a specialist, YOU must obtain that from your Primary Care Provider before the clinic appointment. Please call your HMO or MCO for details.