We have put in place the following policies in an effort to serve you better, and simplify the process of accessing the services that we are privileged to provide to you and your family.

We encourage you to read each of these policies very carefully, and if you have any further questions, please contact us.

Financial and Insurance Policy
Returned Checks Policy
No-Show Policy
Automobile Accident Treatment Billing Policy

PrimeCare Pediatrics requires that you provide all current health insurance information on every patient at the time of scheduling the appointment. Or in the absence of appropriate health insurance, to provide reasonable financial proof acceptable to PrimeCare Pediatrics. We may decline to make an appointment without this information. PrimeCare Pediatrics will verify coverage and confirm that PrimeCare Pediatrics or Dr. Tega is the primary care physician of record. The responsible party must inform PrimeCare Pediatrics of any changes in coverage for existing patients prior to scheduling an appointment. All current patient balances are to be paid prior to scheduling an appointment.

As part of the stipulation in our contracts with health insurance payers, PrimeCare Pediatrics is to collect appropriate co-pays from every patient/parent/responsible party at check in, prior to services being rendered. The responsible party will be required to show proof of current health insurance, by means of a health insurance card, for each patient at each visit. It is the policy of PrimeCare Pediatrics to collect the amount that is the patient's responsibility, such as coinsurances, deductibles, non-covered procedures and tests at check out based on the insurance company allowable. Any non-Medicaid patient qualifying for “Vaccines for Children” must pay for immunizations given on the day of service at check out. Uninsured patients, or persons who are self-pay, are required to pay for all services on the day of service at check out.

It is the policy of PrimeCare Pediatrics to mail as few patient statements as possible, in an effort to reduce healthcare costs.
If a patient's balance, any amount due from the patient is incurred, the responsible party is encouraged to mail the payment directly to PrimeCare Pediatrics upon receiving the Explanation Of Benefits (EOB) from their health insurance company. It is the policy of PrimeCare Pediatrics to mail one statement in an effort to collect the patient due. If 30 days after the generation of the first statement it is necessary for PrimeCare Pediatrics to mail a second statement because no payment has been received, the account is considered over-due and an interest charge of a flat 12% of the balance, but not less than $5, will be added to the account. If no payment is received 10 business days after the mailing date of the second statement, the account will be declared delinquent and turned over to the collection agency. All accounts turned over to the collection agency will also be responsible for the collection agency fees.

No appointments will be made for any children of the responsible party while the account is delinquent or with the collection agency.

Coordination of benefits (COB): The responsible party must respond to the request for information from the health insurance company within 10 business days. This is in the interest of the responsible party to facilitate the processing of any health insurance benefits on their account, and serves to prevent their account from becoming over-due or delinquent.

A failure to respond to a request for COB information from the health insurance company will result in all charges becoming the responsibility of the patient, and or responsible party.

PrimeCare Pediatrics does not accept personal checks. Occasionally this privilege may be extended to our patient population. Any checks returned to PrimeCare Pediatrics for insufficient funds (NSF) will incur a $25 charge. It is the responsibility of the check signer to pay, by cash or credit card, both the check amount and the $25 charge immediately. A failure to respond to PrimeCare Pediatrics within 10 business days will result in the NSF check and charge being turned over to the collection agency. Check signer will also be responsible for all collection agency fees.

1. ROUTINE WELL VISITS: It is the policy of PrimeCare Pediatrics to assess a fee of $25 for “no-show” any time a patient/responsible party fails to notify PrimeCare Pediatrics 24 hours in advance of a cancellation or change to a well (physical) appointment.
2. SICK VISITS: PrimeCare Pediatrics will also assess a $25 “no-show” fee any time a patient/responsible party fails to notify PrimeCare Pediatrics 1 hour prior to a sick or recheck appointment. This allows the scheduling department to try to give the appointment to another family that has a child that needs to be seen.

It is the policy of PrimeCare Pediatrics to mail as few patient statements as possible, in an effort to reduce healthcare costs.

When a “no-show” fee is incurred, the responsible party is encouraged to mail the payment directly to PrimeCare Pediatrics, or make the appropriate payment directly at our office.

It is the policy of PrimeCare Pediatrics to mail one statement in an effort to collect the no show fee. If 30 days after the generation of the first statement it is necessary for PrimeCare Pediatrics to mail a second statement because no payment has been received, the account is considered over-due and an interest charge of a flat 12% of the balance, but not less than $5, will be added to the account. If no payment is received 10 business days after the mail date of the second statement, the account will be declared delinquent and turned over to the collection agency.

 All accounts turned over to the collection agency will also be responsible for the collection agency fees.

We will not be able to make any appointments for any children belonging to the family of the responsible party while the account is delinquent or with the collection agency.

Automobile Accident Treatment Billing Policy

When one of our patients is injured in an automobile accident we understand the automobile insurance (bodily injury that is mandatory for every driver in the State of Georgia) shall be the primary insurance covering the treatment of the injuries.
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The health insurance policy, including Medicaid, shall be secondary.

It is the responsibility of the automobile insurance company to coordinate benefits.

It is the policy of PrimeCare Pediatrics not to bill automobile insurance companies for medical services.

The patient/parent will be responsible to pay for an office visit charge of an amount not less than $85.00 at check-in, before services are rendered.

The balance of the charges for the actual additional services rendered shall be due and payable at check-out before the responsible party leaves the practice.

The prompt pay discount does not apply.

The responsible party will receive an itemized super bill as a receipt for the services rendered with the amount paid and the form of payment included, so they can easily submit the receipt to the appropriate automobile insurance company.