Question 1

Accepted Insurance Providers

Accepted Answer

For well visits, make sure that your insurance company will cover the exam if it has been less than a year since the last one. Some insurance companies require a full calendar year between well visits (starting at age 2 years) while others allow a physical anytime within each year (one in 2017, one in 2018, one in 2019, etc.)

​Here is a current list of insurance companies of which we participate. Please note: that this list is subject to change. If you have any questions regarding insurance, please call our office.

• Aetna
 • Blue Point
 • Blue PPO
 • Cigna
 • EBS Benefit Solutions
 • Emblem Health
 • Empire Blue Cross/Blue Shield
 • Excellus Blue Cross/Blue Shield
 • Fidelis
 • First Option Health
 • GHI
 • Great West PPO
 • HealthNow of New York
 • Healthsource Provident (through Cigna)
 • Healthsource Provident (through PHCS)
 • HMO Blue
 • MultiPlan
 • MVP
 • North American Preferred – PPO, Care Net And Preferred
 • OnPoint
 • Private Healthcare Systems
 • POMCO
 • Preferred Care
 • RMSCO
 • United Healthcare – Empire, HMO, POS, PPO, EPO, Choice Plus
 • Univera Healthcare

Question 2

Accepted Payment Types

Accepted Answer

We accept cash, check, post-dated checks, and Visa or Mastercard.

Question 3

We Require a Copy of Your Insurance Card

Accepted Answer

We need your insurance information to be able to bill your insurance  company. This requires that you give us a copy of your insurance  card. Please note that your insurance policy is a contract between you  and your insurance company. We are not a party to that contract so you  are responsible for understanding your insurance benefits and resolving  conflicts or disagreements with your carrier.

Question 4

Co-Payments Are Due At Time of Service

Accepted Answer

Co-payments are due at time of service, as per your agreement with your  insurance company. Because it costs us more to bill a co-payment than  the co-payment itself, Pediatric Associates charges a $10.00 service  charge if you are unable to pay your co-payment at the time of service.

Question 5

What If I Don't Have Insurance?

Accepted Answer

Full payment is expected at time of service. All accounts with unpaid  balances over 60 days will be assessed a $15.00 monthly statement fee.

Question 6

Unresolved Insurance Claims

Accepted Answer

If we have been unable to resolve  your insurance claim within five months, we will notify you by U.S. mail  requesting you check into the delay. If the claim is still unresolved  after six months, we will request payment directly from you.

Question 7

Familiarize Yourself With Your Insurance Coverage

Accepted Answer

Pediatric Associates cannot always tell you in advance whether or not  your charges will be covered by your insurance plan. Each insurance  company has multiple plans that vary with employer group contracts. We  ask that you be as familiar as possible with your own insurance plan,  including types of coverage and restrictions on use imaging (such as  x-rays), laboratories, and emergency rooms.

Question 8

Usual & Customary Rates

Accepted Answer

Our practice is committed to providing the best treatment for our  patients and we charge what is usual and customary for our geographic  area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

Question 9

Minor Patients

Accepted Answer

The adult accompanying a minor and the parents (or legal guardians of  the minor) are responsible for full payment at time of service.

Question 10

Missed Appointments

Accepted Answer

As a courtesy to our office and  other patients, we request at least 24 hours’ notice for appointment  changes. If an appointment is missed, a no show fee may be charged.

Pediatric Associates

Insurance & Payment Policies

Pediatric Associates

Quick Links

Camillus, NY

Liverpool, NY