Insurance and Billing

What do I need to do to get insurance coverage for my newborn baby?

You need to call your insurance carrier and add your son/daughter to your plan and tell them who his/her pediatrician will be (i.e. Dr. Rako, Dr. Weiner, Dr. Walcott, Dr. King, or Dr. Robertson) and that the name of our practice is Pediatric Healthcare and that we are located at 830 Oak Street. This should be done ASAP otherwise you may get billed for your first few visits with us. If your insurance carrier gets your information incorrectly, you may get billed for your first few visits with us, so make sure they have it right (i.e. have them repeat everything to you).

What do I need to get insurance coverage for my child if I am transferring his/her care to you?

Again you need to call your insurance carrier and change your child's pediatrician to Dr. Rako, Dr. Weiner, Dr. Walcott, Dr. King, or Dr. Robertson and tell them that our practice is Pediatric Healthcare and that we are located at 830 Oak Street.

When should I start to make appointments for a routine physical for my school-age child?

Once your child reaches the age of three, most insurance plans will cover only one physical a year. Some insurances only cover physicals once every two or three years. Many insurances will only cover your physical if it has been at least one year since your last physical. Therefore, it is best to check with your insurance company before you make an appointment with us so that you do not get charged for your visit because you did not know it was not covered.

What is the policy for co-payments?

Co-payments are due when you check in for your appointment. If you do not pay it at that time, you will be charged an extra $10 billing fee on top of your regular co-payment. We take cash, check, or credit cards. Please check with your insurance carrier to find out how much your co-pay is.

Are there co-payments for allergy shots?

Many of the insurance plans do have co-payments for allergy shots. Some have deductibles. Please check with your insurance carrier as to what you are responsible for.

Are the gynecological visits (GYN, Pelvic exams, Pap smears, etc.) covered by insurance?

Some insurance carriers do cover GYN visits separately but many do not. Some insurance carriers will cover either a yearly physical or a GYN exam. Some insurance carriers do not cover some/all of the tests done during a routine GYN visit (i.e. pregnancy tests, Pap smears, STD testing for chlamydia and gonorrhea, and wet mounts are done on all GYN patients). Some insurance carriers have deductibles for some/all of these tests. Please check with your insurance carrier before you come for your GYN visit to see if it is covered otherwise we will bill you if it is not.

What is the policy for the meningococcal vaccines?

Some colleges require you to have the meningococcal vaccine before starting there. However, because it is not required for everyone, some insurance companies do not cover this vaccine. Please check with your insurance carrier to see if it is covered. Otherwise we will bill you if it is not.