Billing & Insurance

Serving Your Financial Healthcare Needs

Whereas our number one priority is to serve the healthcare needs of our patients and their families, we must also make you aware of our financial policies. These policies are necessary to ensure the viability of the practice as well as adhere to regulatory requirements.

Insurance

It is the guarantor’s (responsible party) responsibility to present accurate and current insurance information. We request that you bring both primary and secondary insurance to each visit for review and/or update into our billing system. Providing this information will allow us to appropriately bill your claim for services and alleviate greater financial responsibility for you. It is your responsibility to help us update your information when changes occur throughout the year.

If you fail to bring current insurance information, the services will be considered self-pay. You will therefore be asked to pay for the service on the day of the service. We accept cash, checks, and Visa and MasterCard credit and debit cards. We do not accept American Express.

Please note that Senders Pediatrics is contracted with the following insurance carriers:

  • Aetna
  • Anthem
  • BCMH
  • Caresource – Traditional Plan Only
  • Humana
  • Cigna
  • Cleveland Health Network
  • Emerald Health
  • First Health
  • Great West
  • Medical Mutual of Ohio
  • State of Ohio Medicaid
  • Ohio Health Choice
  • PHCS
  • PPOM/Cofinity
  • SummaCare
  • Tricare
  • United Healthcare

It is your responsibility to understand the insurance companies with which we have contracts. If we do not have contracts with your insurance company you may be subject to out of network benefits which will result in higher co-payments, deductibles or non-covered care.

In addition, it is also your responsibility to understand your healthcare benefits with your insurance carrier. Please understand that there may be co-payment, deductible and co-insurance requirements. In addition, your policy may not cover all services provided by our practice. As such, you may be asked to sign a financial waiver that indicates that you will take financial responsibility for services provided if your insurance company does not cover the service.

Billing for Services

Upon receipt of current insurance information, we will submit insurance claims on your behalf to your insurance carrier. However, please understand that we do not administer your benefits. Your insurance carrier will respond based on the terms of your policy. Any deductible, co-insurance or non-covered service will be billed appropriately to you in a timely manner. As such our anticipation is that you will remit any balance due to us within 15 days of receiving your patient/family statement.

Co-Payments

Co-payments are expected prior to being seen during your check-in process. The practice accepts cash, checks and credit and debit cards for your convenience. If you do not bring your co-payment at the time of service you will be asked to re-schedule your appointment to a time in which payment can be made.

Balance Due

Families will be asked to keep their accounts current at all times. If a balance is due on the family account (for which a statement has been mailed), we will request payment at the time of the next office visit. Payments on or towards these balances are required at this time in order for the desired service to be rendered. Payment arrangements can be made with our Billing Department if needed. If a payment arrangement (interest free) is needed, please contact the billing department. 

Self-Pay

Families that do not have insurance will be billed as self-pay. As such, payment for services will be due at the time of service. We will not bill for these services subsequent from the visit. Upon conclusion of the services performed you will be asked to check-out and present payment for services due. Your charges will be based on services performed for that day. 

Collections Policy

Due to the changing nature of the healthcare market, our collection policies are designed to ensure timely payment for services rendered. We are not a credit agency and cannot therefore carry your debt to our practice. We will send you a statement upon receipt of your insurance payment or explanation of benefits. Any monies due at that time will be expected to be paid upon receipt of your statement.

If payment is not made in a timely manner, our collection process will go into effect and we will no longer be able to schedule well care visits for your child. Upon request for payment with no further response, we will submit your outstanding balance to a collection agency which will prevent us from scheduling further ill visits and functionally discharge your child from our practice. It will also impact on your credit rating.

To speak to a billing representative about your account please contact us at 216-291-9210 option 3 or call the billing department directly at 216-912-0226.