Rose City Pediatrics

Billing Policies

As we continue to provide excellent quality of care to our patients, the passage of the Affordable Care Act (e.g. “Obamacare”) has ushered in a new era in medical care with new benefits as well as some challenges for a conventional, traditional practice such as Rose City Pediatrics Medical Group (“Group” or “Office). It is our intent to address these challenges while maintaining excellence, quality, disciplined and traditional aspects of clinical medical care that we believe have benefited our patients for over twenty years.

One challenge we are facing is to ensure that our fee schedule remains affordable. To achieve this goal, families are asked to follow two options.

1. Leave a Credit Card Number on File in Our Office.

When you receive services in our Office, a claim will be submitted to the insurance company that you have instructed us to bill on your behalf. After that claim is processed by your insurance company, our Office receives a statement (Explanation of Benefits or “EOB”) documenting the amount that has been applied to your deductible, the amount that has been assigned to patient responsibility, and any other unpaid charges. With our new procedure, we will now bill your credit card for the amount the Group is owed and will provide you with a statement showing all charges, the amounts paid, and a “paid in full” notation. The amount the Group will charge your credit card will be the Group’s fee to provide the care to the patient less the amount received by the Group from the insurance company for the care provided. A negotiated rate based on your insurer may apply.


2. Advanced Beneficiary Notice

Please print, review, and sign this form. This form reviews important issues, including your right to notice of charges for professional services, how we interpret and adjudicate insurance EOBs, choices with regard to obtaining services from us that insurers do not cover, and third party billing agreements.

No single entity is more sensitive to how the ever-evolving landscape of healthcare affects young families than are we. As a relatively small pediatric medical practice committed to the health and wellbeing of your children and families, we are finding it ever more difficult to successfully offer an uncompromising high level of care to our patients while simultaneously seeking reimbursement at an amount adequate to sustain our operations. The implementation of these new policies is our attempt to continue to provide quality, affordable and accessible medical care to your children during a period wherein the entire healthcare industry is going through very tumultuous changes.

We appreciate your understanding in this matter and we look forward to continuing to serve you and your family. If you have any questions, please do not hesitate to contact us at the Office.