Burke Pediatrics, LLC 2022

Our practice is committed to quality medical care. We are your child’s medical home! As part of that, certain financial responsibilities must be respected.

The parent /guardian who responsible for all charges and payments. If the Insurance changes, please notify us right away.

INSURANCES

We have attempted to participate in all insurance plans. This is regardless of their reimbursement to our practice for services provided.  Your insurance plan contracts with us and requires us to abide by its rules for payment, and coverage (which services will be covered).  These may not always be the services or medications that a child needs. We will try to respect that arrangement but will never compromise your child’s health.

All payments for anticipated services must be made at the time of registration.

COPAYS

We are by contract obliged to collect this fee at the time of your visit and must be paid at the time of registration for each visit. Please have your co-payment ready at check-in. Usually Co-pays are waived for Well visits, However if an additional diagnosis is made during your Well Visit, the insurance will require the co-pay.

DEDUCTIBLES

Each insurance plan has different benefits and deductibles.  We will always take that into consideration.  If at your visit, we cannot establish exactly what your obligation is, we are forced by circumstances beyond our control to assess a charge for payment. This must be paid at the time of the visit. Once your insurance informs us that the deductible has been met, your account will be adjusted. 

ADDITIONAL SERVICES at HEALTH ASSESSMENT

Often unknown to patients are the “insurance billing rules.”  For example, co-pays for health assessments (well child care) are most often waived; however, if a medically significant diagnosis is addressed, insurance rules require us to report that diagnosis. They usually then require a co-pay for that service. Also, if lab work is ordered, please be sure that the lab has your correct insurance information. Otherwise, they will bill you.

COLLECTIONS

You should make full payment (or call to set up a payment plan) within a reasonable time period. If not, the balance may be sent to collections. We may also pursue legal action to obtain payment. If you’re having difficulty meeting medical bills, we would be happy to help you by setting up a payment plan. Otherwise dismissal from the practice may occur.

SPECIAL CIRCUMSTANCES

We are committed to providing excellent medical care to your children.  We understand that medical care can often be unexpected and expensive, and also that personal financial circumstances can change.  We do not wish that to affect your child’s health and care. Thus, our policy is to consider and possibly make exceptions for a short period of time. For this consideration, a parent/guardian must speak with a member of our business office before any services occur.

We are also happy to work with families to create a payment plan. Just ask us!

PATIENTS WITHOUT INSURANCE/SELF-PAY

If you do not have health insurance, payment must be made at the time of registration.  We are also happy to make payment plans.

MISSED APPOINTMENTS

Life and traffic happens, so we understand that sometimes you cannot make your appointment. Please call us to cancel 24 hours in advance or to change an appointment. If you don’t call to cancel in advance, we reserve the right to charge a No-Show Fee (currently $25) to cover the cost of the missed physical/ well child visit and the same will be applied to any missed sick visits. Missed Consultation appointments will be charged $50. Multiple missed appointments, or failure to comply with other Burke Pediatrics policies, may result in dismissal from the practice.

RETURNED PAYMENTS

If you pay by check/credit card and your payment is returned due to insufficient funds, you will be responsible for the amount of the payment, and a returned payment fee $35. If this occurs multiple times, we may require all future payments in cash.

FORMS

Health insurance programs do not cover the cost of researching, filling out and signing forms. We charge a small fee $25 to cover these costs of completing forms. The fee will charged at the time the form is submitted. Please allow three business days for completion of the form.

MEDICATION REFILLS

Only certain medications can be safely refilled without a patient visit and reevaluation. During office hours, the physicians are concentrating on the patients in the office and therefore, will often deal with refills once all patients are gone. Because of this plus the additional research into the chart and pharmacy notification, a $25 fee will be assessed for all refills outside of an office visit.

MEDICAL RECORDS

Your child’s medical records are now available on-line via our PATIENT PORTAL, including immunization records. If you desire the entire record or a printed copy, you must make a written request. Please allow five business days. A minimum charge $25 must be paid at the time of the request.  VA Law requires record retention of 6 years from the date of the last visit and the patient age of 18 years.  We have chosen to keep your child's records on file up to age 21 years to assist with college entry requirements.  Please allow additional time 1-2 weeks for research time if your child is over 18 years old.

SPORTS PHYSICALS

Virginia Department of Education requires that this physical occur on/after May 1 of current school year for the following sport seasons. We recommend yearly physicals for all children and teens. For athletes, please schedule this health assessment after May 1 for the following school year. Insurance may not cover this but we are happy to do them with your annual visit if it satisfies the State, School and Insurance requirements. If not covered, the physical and form can be done for a fee of $120.

SATURDAY VISITS

These appointments are to help prevent a visit (and wait) to the emergency room or urgent care. Appointments are encouraged.  We are open 8:00am to 12:00pm from Labor Day to Memorial Day.  A weekend fee is charged to insurance.  Walk-ins and Newborns are encouraged.

AFTER HOURS TELEPHONE SERVICE

Whenever our office is not open, you may contact our professional medical answering triage service.  If it is not a true medical emergency, a $30 fee will be assessed.

A practice physician is always on call 24 hours everyday all year long.

FLUORIDE APPLICATION

This usually occurs at your child’s well visits from the time they have teeth through the age of 3. Most health insurance programs cover this service. If not covered, the application can be done for $25.

VACCINES

Vaccines are usually covered by health insurance at no out of pocket expense. If you do not have any health insurance, and your child is under age 19 years, the vaccines are provided free through the Virginia Vaccines for Children (VVFC) program.  An administration charge of $21 will be assessed for each vaccine as allowed by VA Law.

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