Insurance and Financial Policies

Financial Responsibility

Our practice is committed to providing the best care for our patients. Your provider will bill the insurance you provide to us at the time of your service. In order to bill your insurance company, we need timely, updated and correct insurance information. Keeping us informed of the correct information is your responsibility. You will be asked to show your insurance card at every visit to ensure that we have the most up to date information.


Insurance co-pays are expected to be paid at the time of service. If you have a balance on the account, our front office staff will ask to collect it at any appointment. Our billing department will be available upon request to make other arrangements if needed. Self-pay patients are expected to pay for services in full at the time of visit. See Statements and Payments below for more information if you are a self-pay or out of network patient. It is ultimately your responsibility to understand your insurance benefits. Please do not hesitate to contact our billing department with questions.


  • Insurance and Billing

    We are contracted with most preferred provider (PPO) insurance plans. We only accept an HMO plan if it is through your employer and the medical group is Regal Medical Group of LA. Many of the insurance plans that we are contracted with have network specific plans which we may not be a part of. We strongly suggest that you contact your insurance plan prior to scheduling an appointment to verify that your doctor is in network. 


    You will sign our financial agreement form, which assigns direct payment from your insurance company to your pediatrician. Please be aware that some recommended services may not be covered by your insurance plan. It is your responsibility to know what type of health insurance policy you have and understand the limits and coverage it provides. Please understand that if you consent to and accept any service recommended by your doctor, payment is ultimately your financial responsibility, regardless of what coverage your insurance provides. You may be asked to sign a Waiver Agreement for specific tests that your doctor recommends that your insurance will not cover. This will be discussed prior to testing done, if applicable.  


    Insurance coverage can be very complicated. Please do not hesitate to contact our billing department with any questions. We make every effort to make it as easy for you as possible. If you have questions about your coverage or explanation of benefits, you may also check with your specific insurance company, and we strongly recommend for you to document any discussions you have with your insurance company.

      

  • Statements and Payments

    We strongly encourage you to create a family account with InstaMed to receive e-statements and make online payments. We also accept checks and major credit cards. A service charge of $35 will be due for each returned check. 


    All co-payments will be collected at the time of service unless you set up direct payment via InstaMed. There are also many options via InstaMed to pay outstanding balances. Otherwise, outstanding balances due will be requested at each visit. A statement for any services will be sent to you after we have billed for your child’s visit and received a response from your insurance company. Payment will be due at that time. 


    Self-pay patients are expected to pay for services in full for each visit at the time the services are rendered. This includes patients with out of network insurance plans or cost sharing/share of cost plans. Our billing department will be happy to try and submit the claim for you or provide the necessary documentation for you to file the claim for reimbursement with your insurance company yourself. 


    Our billing department will make every effort to contact you regarding outstanding balances. Please avoid waiting to be sent to an outside collection agency to discuss any issues. We are always willing to work with patients who make reasonable efforts to pay for their care. 


  • Annual Family Fee

    Our priority has always been to provide your children with exceptional, compassionate care and to make your family’s experience as smooth and supportive as possible. Over the years, we’ve added many services that go beyond what insurance covers. Services designed to make your care more accessible, convenient, and personalized. To continue offering this level of care, we have an annual family plan fee that helps us maintain these additional benefits, including:


    • Same-day and urgent appointment availability 

    • Extended weekend hours 

    • Curbside vaccination and viral testing clinics 

    • Access to all seasonal vaccines 

    • Fast turnaround for school and camp forms 

    • Faxing documentation to schools and specialists 

    • Maintenance of secure electronic medical records 

    • Assistance with insurance authorizations 

    • Phone and written communication with advice nurses and physicians 

    • Access to one of our physicians on-call 24/7 


    The cost of the annual fee is based on who your primary doctor is and the number of children you have. For most doctors, the fee is $200 for one child, or $300 for families with two or more children. For Dr. Daniel Bruckner, the fee is $500 for your first child, $250 for each additional child, with a maximum of $1,000 per family. For Dr. Nancy Zimble and Dr. Howard Reinstein, the fee is $150 for one child, $200 for families with two children, and $250 for families with three or more children. This fee will be automatically charged to your account annually on the anniversary of your original payment. 


    We truly value the trust you place in us to care for your family. If this fee presents a hardship or if you have any questions, please reach out to us. We’re always happy to discuss options and find a solution that works for you.




  • Canceled or Missed Appointments

    Much effort goes into preparing for your well-child visits and consultations, and the extra time allotted to those appointments is valuable. If you are unable to keep your appointment, please be considerate of your doctor's time, as well as other patients who may need to be seen. Please contact us no later than 24 hours before your scheduled appointment to cancel. 


    A $50 fee will be charged for a missed well-child appointment, unless you call at least 24 hours in advance of your appointment to cancel. We understand that there are sometimes extenuating circumstances so we will apply this policy judiciously. 


    If you have any other type of appointment scheduled, please also call to advise us as soon as possible if you are not able to make it so we can offer that appointment to someone else. It would be truly appreciated!