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Read Our Office & Financial Policies Please review our most recent office & financial policies by clicking on the link below:
Financial Policies
Our business relationship with you is an important part of serving as your "medical home". Changing conditions in the economy and health insurance industry have made the cost of health care challenging for both patients and health care providers. Accordingly, we have developed financial policies that we believe are transparent, fair and patient-friendly. We encourage families to understand our financial policies in order to ensure that we maintain an optimal business relationship. A complete copy of our office and financial policies can be found by clicking on the link below (or may also be obtained at any of our offices).
Our Charges
- Our fee schedule has been developed to be consistent with usual and customary charges in the community and is available for patients to review at any time.
- We charge for all services provided by our health care providers.
- We do not charge for services provided by our registered nurses through our nurse advice line or for our after-hours service.
- Please be aware that if any outside lab or x-ray services are required, you will receive a separate bill for those services from the lab or x-ray provider.
- We complete most simple forms for our patients at no charge; however, there may be a charge for more complex forms.
Payment Options
- We expect payment in full at the time of service unless the service is covered by insurance.
- Patients are responsible for paying co-payments at time of service. Please remember that we do not set your co-payment amount. Your co-payment is contracted between you (or your employer) and your insurance company, and we are not allowed to waive or reduce co-payments.
- As a service to you, we will bill any remaining co-insurance, deductible, and non-covered services to you after your insurance has processed our claim. We request payment within 30 days for these charges.
- We accept payment by VISA, MasterCard, Discover, American Express, as well as by electronic and personal check. Cash payments are accepted in our offices.
- Secure online credit card and electronic check payments may be made by clicking on the link below:
Online Credit Card/E-Check Payment
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Health Insurance
Advanced Pediatrics accepts most insurance plans (including some Kaiser POS and PPO plans) and participates with the Medicaid PCP program, CHP+, and Tricare. Differences among insurance policies in the marketplace have become increasingly complex over the years, and it has become impossible for our practice to know each specific plan and their limitations. Therefore, it is your responsibility to know your insurance benefits. Your insurance policy is a contract between you and your insurance company, and we are not able to modify coverage, co-payments or deductibles. We do not accept insurance discount plans. For more information regarding health insurance, click on the following:
Understanding Your Health Insurance
Insurance Company Links
Understanding Discount Health Plans
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Insurance Changes
If you have changes in your insurance it is important to update this information with us so that we can send in your claim accurately. Having the correct insurance information in your medical record is also important for our clinical providers to make sure any necessary lab work is sent to the right clinical lab and to make sure we process referrals correctly. If you have changes in your insurance (a new insurance plan from your employer, a change in jobs with new insurance, or new dependents), please let us know when making your next appointment.
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Adding Your Newborn to Your Insurance Plan
Please make sure you add your newborn to your insurance plan within 30 days of birth to ensure coverage. The first year of life can be expensive because of recommended well-care visits and immunizations. If you have any questions regarding your insurance coverage please contact your health care plan, your employer or our patient business office. We can usually help you understand which services are covered and what out of pocket expenses you should anticipate. For information regarding average pediatric charges for the first year of a newborn's life, please click on the link below:
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Patients With No Insurance
Patients with no insurance are expected to pay for all services at the time of service and may be asked for a deposit prior to the visit. We have several options to help our patients without insurance coverage:
- We offer a 10% discount for payment in full at time of service.
- Patients with no insurance are eligible to receive vaccines from the State of Colorado's "Vaccines for Children "(VFC) program at a cost of $14.50 per immunization.
- Advanced Pediatrics works in cooperation with The Children's Hospital residency program and provides appointments with a resident physician at a 50% discounted rate for the office visit for patients with no insurance. These appointments are available at our Aurora office.
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Have Questions or Need Assistance? Contact our Patient Business Office!
Please feel welcome to contact our Patient Business Office if you have questions about our financial policies, your insurance benefits, or your patient account. Our staff is experienced, knowledgeable and always happy to help you with any insurance or account questions you may have.
Patient Business Office
Phone: 720-870-4740, option 1
Fax: 303-597-0225
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Understanding Your Health Insurance
Sometimes lower premium, higher deductible plans sound appealing, but families are often surprised at the services that may not be covered or are included in the patient's deductible. This is particularly true for families with young children who have more frequent illnesses and significantly higher well-care costs because of necessary immunizations. We encourage you to fully understand the benefits of your plan so that you are aware of your financial responsibilities, including co-payments and any out-of-pocket costs that may be incurred. We suggest that you ask your insurance company the following questions regarding your health insurance plan:
- Does the plan cover well care visits? Some plans do not cover any well care visits or cover them only for specific ages. Plans may also have an annual or life time maximum amount that will be paid towards well care visits.
- Are there restrictions to vaccine coverage? Some plans only cover certain vaccines, or for certain ages, or may have a maximum annual limit for vaccine coverage.
- How often are well care visits covered? Some plans require a full 365 days between these visits.
- Does the plan cover (or limit) sick visits?
- What co-pay, deductibles and coinsurance amounts does the plan require for well care and sick visits? Are deductibles per person or for the entire family?
- What coverage does the plan have for in-office lab work? Not all in-office labs are covered at 100% and/or may be applied to your deductible and coinsurance.
- What coverage does the plan provide for emergency and urgent care visits?
- Does the plan require a referral to cover a visit with a specialist?
- What hospitals are covered by the plan?
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Insurance Company Links
For your convenience, we have included links to some of the major insurance companies:
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