REGISTRATION AND INSURANCE
To help with registration please print out and complete the following forms (click here to download) and bring them to the office. Be sure to bring your insurance card, photo ID and a method of paying for your co-payment and/or deductible to each visit.

YOU AND YOUR INSURANCE
You are responsible for the charges for your visit. Your insurance policy is a contract between you and your insurance company; therefore, payment is your responsibility. However, as a service to our patients, KIDS TIME PEDIATRICS will file the claim for your visit with your insurance company. We require proof of insurance coverage (valid insurance ID card) at each visit. KIDS TIME PEDIATRICS has a contract with most insurance companies that allows Kids Time to submit the claims to your insurance company on your behalf. You are personally responsible for payment if your insurance company does not pay the claim. For your convenience we accept cash, check, debit cards and Visa, Master Card, Discover, and American Express.

PAYMENTS
All co-pays are due at the time of service. The co-pay cannot be waived. Any co-pay not collected at the time of service will incur a $15.00 billing fee, payable by the insured member.
If at the time of service, we are unable to verify the amount of your co-pay, co-insurance, or deductible, we will collect a $20.00 payment. This payment will be used toward your co-pay, co-insurance, or deductible. If this payment turns out to have been collected incorrectly, the difference can be credited toward a future visit or refunded, at the request of the patient.

INSURANCE PLANS
KIDS TIME PEDIATRICS is an in-network provider with major commercial plans including, but not limited to: Aetna, Beech Street, Blue Cross Blue Shield, Cigna, Coventry Network, Humana, PHCS-MultiPlan, Principal, and United Health Care. Some locations also accept Medicaid (Amerigroup, Peachstate, Wellcare) and TriCare (referral required). Check with your local office to verify Medicaid and/or TriCare participation.

MEDICAL RECORDS
As part of our insurance company fee, KIDS TIME PEDIATRICS will provide your insurance company with the information needed to process the claim for your visit. Patient requests for copies of claims, records of payments, etc. are subject to an administrative fee of $15.00 per request. This fee must be paid prior to completion of the request and is not covered by your insurance company.