Call Us Today: 302-684-0561

 

 

 

Welcome to Sussex County’s trusted name in Pediatric & Adolescent Care

“Pediatrics is definitely my passion.”

Lauren-Griffin Walls, FNP

Insurance Information

We participate with most insurance companies including:

  • Highmark
  • Aetna
  • United Healthcare
  • Cigna
  • Tricare
  • Coventry
  • All Delaware Medicaid Plans

**Out of state Medicaid is not accepted at our practice.

You must present all current insurance cards at each visit. If you are unable provide us with current insurance information, payment for the visit will be required at the time of service. We are required by your insurance company to collect any and all co-pays at the time of service. It is your responsibility to know your health insurance benefits.

Please contact your insurance company if you have any questions regarding coverage and benefits.

All newborns must be enrolled with your insurance carrier within 30 days. Otherwise, you could be responsible for all charges.

There is a fee to copy medical records and complete health forms. These fees are not billable to your insurance company.

Information for Uninsured Patients

Below we’ve listed some things that you may find helpful as a patient without Insurance. Since insurance companies “negotiate” a contract with Healthcare Providers, frequently uninsured patients don’t know what questions to ask and sometimes end up with a large bill or confusion about what they are paying for.

Every visit is not charged the same

There are many factors that go into coding an office visit such as Systems reviewed, History, Complexity of the issue, Time spent with the patient and Level of Decision Making. This is not an area that can be negotiated. By law, providers must code the visit level appropriately. Asking a provider to change their level of coding is asking them to commit a fraud.

Payment Due at the time of service

We do require you to pay $100 (amount of an average visit) at check-in. If your visit is more, we will balance bill you. If it is less, we will leave a credit on your account to apply toward your next visit.

Every Procedure or Test is an extra fee

Our providers are completely in a “Clinical” mindset, meaning they don’t usually have any idea what your insurance status is. They think only in terms of taking good medical care of your child, therefore at times the Doctor may order future testing to confirm you child’s diagnosis. Please know that Strep Tests, Flu Swabs, Ear Washes, Nebulizer treatment and Wart Removals are the most comment tests performed at an extra fee. Also, any specimen collected in the office and sent out for further testing will incur a charge to you from the Lab it is sent to. Feel free to ask the provider if the test is necessary at this time if you feel this is a hardship. We will balance bill you for any “extras,” you will not be expected to pay at the time of service.

 

Call Us Today: 302-684-0561