Insurance/Billing

COPEDS accepts most all major insurance carriers. It is our sincere desire to provide the best possible medical care and to assist you with maximizing your insurance benefit. We will strive to provide you with as much help and assistance as we can to help you understand and get the most from your plan. For many if not most families, a medical insurance program is available and can offset the cost of medical services considerably. Insurance coverage does not, of course, mean that "everything is paid for in full." Very often, patients must still pay out of pocket for deductibles, co-pays, and co-insurance amounts, as well as for services that are not covered as part of a particular plan. Please let us remind you that our services are provided directly to you and not to your insurance companyAnd since the specific provisions of these plans change all the time, you need to confirm our participation status and the details of your coverage before you make your first appointment. Remember, too, that many of these programs require pre-approval and/or specific primary care referral, and it is the patient's/parent’s responsibility to secure such pre-approval or referral if insurance is expected to cover the treatment we render.

 

INSURANCE FAQ

Q – DO YOU ACCEPT MY INSURANCE?
A – COPEDS participates with most major insurance companies. For the most accurate and complete information, refer to your handbook or call your insurance company.

Q – WHAT IF YOU ARE NOT A PROVIDER IN MY INSURANCE PLAN?
A – COPEDS provides services to many small and a few large insurance plans as an out-of-network providerWhen an individual utilizes the out of network provider option, this means that the physician does not have a contract with the insurance company, but the plan will partially cover the cost of the office visit. For patients we see “out of network,” we require a minimum of 50 percent payment at the time of your appointment.

Q – CAN I COME TO COPEDS IF I DON’T HAVE INSURANCE?
A – COPEDS welcomes all patients, with and without insurance. We do require that you pay for services at the time of service. We accept cash, check, and most major credit cards.

Q – DO I HAVE TO FILE A CLAIM WITH MY INSURANCE COMPANY?
A – Not all insurance plans require that we submit claims on your behalf. However, as a service to our patients, COPEDS files all insurance claims. Generally within 2 working days the claim from your visit will be electronically submitted to the insurance plan we have on file for you/your child. Please note, however, that we will submit each claim one time only. If payment has not been received within 30 days, the responsible party will be billed.

Q - WHEN IS A REFERRAL REQUIRED?
A - Be sure to read your specific insurance policy as to subspecialist care. Generally a referral is required anytime you see a physician other than your primary care physician.

Q – WHY IS A CO-PAY DUE AT THE TIME OF SERVICE?
A – A co-pay is a requirement of your insurance company. If the co-pay is not paid at the time of service, some insurance companies may hold you responsible for the entire bill.

Q – WHY DOESN'T MY STATEMENT SHOW MY PAYMENT?
A – Please allow 10 days for your payment to be credited to your account. If it has been more than 10 days, please contact our business office at (614) 839-3040.

Q – HAVE YOU BILLED MY SECONDARY INSURANCE?
A – We will bill your secondary insurance when we have received response from your primary insurance. Your statement will show the name of your insurance company most recently billed.

Q – WHAT IF WE CHANGE INSURANCE PLANS BETWEEN APPOINTMENTS?
A – When your insurance situation changes, please inform us as soon as possible. 

Q – WHY IS IT NECESSARY THAT MY INSURANCE CARD BE COPIED EACH VISIT?
A – We ask that you provide us with updated and accurate information regarding your insurance plan, home address, and current telephone numbers for home and employment. You will need to provide us with a copy of your current insurance card each time you visit our office. We realize that this may be frustrating for you; however, it is important that we make this part of our routine since payment relies on your information provided to our office.

Q – CAN MY UNDER 18 YEAR OLD CHILD BE SEEN WITHOUT A PARENT IN ATTENDANCE?
A – Once we have a signed parental permission form on file along with insurance information verifying that the child is included on the plan, we can evaluate and treat children less than 18 years of age.

 

A copy of our financial policy can be viewed here.

 

Further questions? Email our billing specialist Anna Aldridge at aaldridge@copeds.com or our practice administrator at dseiple@copeds.com or call (614) 839-3040. We attempt to respond to email questions within 48 hours. 

 

For specific billing inquiries, please fill out the following online form and our practice administrator will contact you:

Requestor's name *
Requestor's name
Patient name *
Patient name
Patient date of birth *
Patient date of birth
Requestor's preferred contact phone number *
Requestor's preferred contact phone number