We’re glad that you’ve chosen us as your child’s pediatrician. We understand that in addition to feeling comfortable with your child’s healthcare, many parents also have concerns about the financial policies of the practice. The following information is designed to answer frequently asked questions.

Lockman & Lubell Pediatric Associates has agreed to file insurance claims for patients who participate in plans with which we have a contract as a “participating provider”. Insurance companies we currently accept. In order to do this as accurately as possible, it is our policy that:

We will attempt to verify your child's health coverage by internet before your arrival for your child’s visit. 

At the time of EACH visist we  MUST SEE  YOUR CHILD'S HEALTH INSURANCE CARD.

If your child is covered by a managed care plan, one of our physicians' names must appear on your health insurance card.

It is the parent's responsibility to have this information available to whoever is bringing the child for the visit (spouse, grandparent, nanny, etc).

IF YOU DO NOT HAVE YOUR CHILD'S INSURANCE CARD AT EACH VISIT OR ANOTHER PHYSICIAN’S NAME APPEARS ON THE CARD, YOU MAY BE ASKED TO SIGN A WAIVER AND LEAVE PAYMENT AT THE TIME OF VISIT

We collect all CO-PAYMENTS AT THE TIME OF SERVICE and file insurance claims on a daily basis.

Charges for any services that are deemed to be the responsibility of the guarantor (additional copays, coinsurance, deductible, etc.) or that are for “non-covered”  services (example-ear piercing) by your insurance plan will be applied to the “patient balance” and are due immediately.

Any claims that we file with your insurance company that are not responded to any time after 60 days from the date of service may be transferred to patient balance. This balance will remain the responsibility of the family until payment is received or written correspondence is received from the insurance company verifying that payment is forthcoming from them.

A monthly statement will be sent to you detailing unpaid charges. If you have questions regarding items which have not been paid by your insurance, we ask that you contact your insurance company or employer as benefit packages vary by employer. You may also contact our billing office at 888-876-0347 or call our office manager, Margie Lieberher. Any bill not satisfied within 90 days will be submitted to a collection agency and reported to a credit bureau. 

Non-Contracted Insurance or Self Pay:


If we do not participate with your insurance plan, we ask that you pay in full at the time of services. We will provide you with an “encounter” form suitable for filing with your insurance company. You need only to fill out your portion of the insurance claim firm, attach our encounter from and mail to your insurance company.

Separated/Divorced Families:

For those families where parents are separated or divorced, the parent authorizing treatment of the child is responsible for payment for services rendered. In the case of insurance coverage with a company with which we are contracted, the copay is due at the time of service. Subsequently all charges deemed parental responsibility by the insurer are due to Lockman & Lubell Pediatric Associates by the parent who authorized treatment.

If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent's responsibility to collect from the other parent. Lockman & Lubell Pediatric Associates will not act as a mediator in collecting our payments.

A copy of the bill with appropriate insurance coding will be given to the authorizing parent at each visit. If the account is not resolved in a timely manner, the authorizing parent's information will be submitted to our collection agency.

Lockman & Lubell Pediatric Associates is currently closed to the following insurance companies:

MEDICAID/ACCESS- Currently, we are only open to established patients who change their child's health coverage or the siblings of an established patient. Please read below regarding definition of established patient*

*AN “ESTABLISHED” PATIENT IS SOMEONE WHO HAS BEEN SEEN BY ONE OF OUR PROVIDERS IN THE LAST 3 YEARS AND HAVE NOT TRANSFERRED OUT OF OUR PRACTICE.

 

NON-COMPLIANCE WITH THESE FINANCIAL POLICIES REPRESENTS A BREACH OF PARENTAL RESPONSIBILITY AND MAY RESULT IN DISMISSAL FROM THE PRACTICE. 

2/8/14