Our billing policy has recently changed. Please review prior to your appointment.
Under the Affordable Care Act, families are having their insurance changed to new insurance products, as mandated by federal law. As a result, traditional insurance products utilizing legacy PPO networks are no longer accessible for many of our patients, though some who obtain their insurance through unions or government agencies may still have access. The state of California has not adopted the federal extension allowing individuals and families to keep their plans for an additional two years, so in most cases families do not have the choice to keep their legacy networks or the doctors who are in them.
While our contracts with insurers have not changed. The policies insurers offer has. Insurers have manufactured new, “narrow” networks that have arbitrarily excluded Rose City Pediatrics. Insurers admit that these new, narrow (usually EPO) networks are designed to fulfill insurance companies’ needs for a minimum number of “providers or prescribers” and to fulfill the needs of the insurance companies’ members at the lowest cost to the insurance company. Confusingly, many of these new network plans are marketed and advertised as PPOs, which we believe they are not. We have only ascertained the truth after families accessed our services.
As a result of the Affordable Care Act, and because of diminished access from new limited assurance networks, and although our existing relationships with insurers has not changed, we have been forced to implement new billing policies to remain viable.
If we cannot quickly determine if we will get paid we will charge you $125.00 deposit at the time of service and we will refund when if we get paid.
We appreciate that our families value the traditional and high quality services they have come to expect, and that we expect from ourselves. With apologies for any inconvenience this may cause, bat assuring you of our best attention at all times, it is our intention to continue to provide the caliber of care our patients have enjoyed over the years.