Essex Pediatrics is dedicated to providing you with the best possible care and service. Your clear understanding of your financial responsibilities is an essential element of your children’s care.
Unless other arrangements have been made in advance by either you or your health coverage provider, full payment is due at the time of service.
We understand there are times when extenuating circumstances cause financial hardship. If this occurs, please contact our billing office to discuss a payment plan.
- Essex Pediatrics accepts cash, in-state personal checks, Visa, Mastercard, Discover, American & Express.
- There is a service charge of $20 for returned checks.
- There is a $7 fee for each bill sent after the initial statement.
- All fees from our collection agency for overdue account balances will be your responsibility.
- Any account sent to our collection agency for lack of payment may be dismissed from our practice.
- Inquiries regarding charges for procedures are the responsibility of the patient/parent.
- The expense for services provided is the responsibility of the legal guardian escorting the child, regardless of existing legal arrangements. Except in limited circumstances, such as in the case of an emancipated minor, all legal guardians are financially responsible for their children’s care.
- Refunds: Upon written request within 30 days, overpayments will be refunded to the responsible party.
*Insurance Billing and Coding Update*
Over time, some insurance companies have changed how they are covering visits and/or applying parts of some visits to deductibles and patient cost-sharing agreements.
Preventive care visits can go by different names, such as Check-Up, Annual Physicals, Wellness Exams, Well Child Exam, etc. These are “healthy care visits”. These appointment schedules are based on national guidelines and are made to discuss routine preventative care, and lifestyle management, update your immunizations and screening tests, and generally address issues to keep you healthy. Most insurances cover these visits in full without co-pay or deductibles applied. Unfortunately, there are increasing circumstances where insurances are not covering certain procedures, treatments, topics, or concerns under the umbrella of a “well-child visit”. Instead, insurance companies increasingly categorize concerns not covered under a well visit as “Evaluation and Management” visits, meaning the concern could exist as a separate stand-alone appointment.
In part to improve access and to decrease the number of visits families have to make, we always try to address all of your concerns during any visit. There may be office visits, including annual physicals, where the scheduled time is not sufficient, and a follow-up visit may need to be scheduled. However, when time allows, we will try to address these additional concerns during the active visit.
During a preventative care visit, if we address additional problems, topics, or concerns, or we address any ongoing chronic medical conditions, we must also document and claim these problems to your insurance company. Depending on your insurance, these additional problems will often be subject to co-pays and deductibles, so you may receive an additional bill for this service.
What most insurances consider part of the Preventative of Routine checkup:
- General physical exam based on age
- Growth and vital signs
- Screening tests based on age and/or risk factors
- Advice and information about staying healthy and establishing healthy habits
- Identifying risk factors for certain conditions
- Immunizations
What most insurances consider “Evaluation and Management” visits:
- New illness or injury
- Chronic/recurrent symptoms
- Targeted diagnostic testing
- Developmental, Behavioral, and/or Social-Emotional concerns
- Management of chronic conditions, particularly ones that require ongoing medication management and/or coordination with resources, including Asthma, Depression, Anxiety, ADHD, Autism, Diabetes, etc.
- Care Coordination, referral coordination
- Chart Review, including visits to specialists, consults, interpretation of labs, etc.