Insurance Information
Our office does not contract with any HMO Plans. Below are some of the Major PPO Plans Lapeer Pediatrics is in network with:
• Assurant Health PPO
• Anthem Blue Cross EPO
• Health Net PPO
• Blue Shield PPO
• Directors Guild of America (DGA)
• Screen Actors Guild (SAG)
• Cigna PPO
• Motion Pictures Insurance (MPI)
• Aetna PPO
• Tri-Care
You will need to call your insurance carrier and verify our participation in your network, and what deductibles and co-pays you are responsible for. We also suggest that you familiarize yourselves with your policy regarding well check ups. We will be pleased to bill insurance for you, but it is imperative that you keep your insurance information current in our system. Please be sure to notify us as soon as possible of any changes in insurance, address or phone numbers.
All co-payments, outstanding balances and deductibles are due prior to checking in or out for your child’s appointment. You will be billed after your insurance has reconciled for any benefits not covered. Remember newborns must be added to your insurance plan within the first 30 days.
Annual Administrative Fee
Our annual administrative fee covers non-reimbursed services including but not limited to:
• preparing reports for consultants and insurance companies
• completing health forms for school and camp
• writing letters for airlines and schools
• faxing or calling in prescriptions
• copying and sending medical records
• having a doctor from the practice always available for phone consultation with access to your electronic medical record
The administrative fee is structured to reflect family size as follows:
• Families with one child: $350 per year
• Families with two children: $450 per year
• Families with three or more children: $500 per year
Open Payments Database Notification
Pursuant to Assembly Bill (AB) 1278, a link to the Federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
https://openpaymentsdata.cms.gov/
Missed Appointment Fee
If an appointment is not cancelled with at least 24 hours notice, there is a $50 missed appointment charge.