Patient Info Billing Policies

Billing Policies

Agave Pediatrics is contracted with a most Insurance Plans. If we have a contract with your plan, we will bill the insurance company for the services we provide in the hospital or in the office. Services not covered by insurance plans with be billed to the parent directly.

Insurance Pre-Verification

We try to contact insurance companies prior to your appointment to facilitate the registration process. Please let us know if your insurance has changed at the time of making the appointment. This will make it possible for us to verify your insurance the previous day and will decrease your wait time.

At the time of your visit please bring the following items:

  • Patient’s insurance card
  • Co-Pay and/or balance due will be collected at time of service.
  • Medical records from other offices (if available)
  • Patient’s vaccine records (if available)
  • Parent and/or Legal Guardian must accompany the patient for initial visit

If you have an HMO insurance or are on AHCCCS, you must call your insurance company before your appointment date to make sure the patient is assigned to one of our providers or offices as their PCP (Primary Care Provider). If the patient is not assigned to us upon your appointment time, your appointment may be rescheduled.

Please bring your child’s insurance card with you to every visit. We will make a copy of the card. This copy is used to submit an insurance claim for the visit. It is very important that the insurance card be a current copy and that the card lists the name of the child, who is being seen for that visit. If you have recently enrolled in a new insurance plan, you may bring a copy of your enrollment form until you receive the new card.

For newborns, we are able to accept a copy of the parent’s insurance card up until the first month visit. After that time, we must have a copy of the child’s card which will be required at the time of check in.You are required to add your child to your insurance plan within 28 days. Failure to do so may result in nonpayment of claims made.

If you are unable to present a current insurance card for your child, you will be asked to sign an Insurance Coverage Waiver form.

Co-payments

We collect all patient co-payments at the time of check-in. If a patient balance is generated after a claim is submitted to a contracted insurance plan, we expect payment in full after a bill is generated. We follow standard collection procedures for all unpaid balances.

We are pleased to accept cash, check, MasterCard, Discover, VISA or AMEX for your convenience. If you need to arrange a payment plan, please contact our Billing Office.

Insurance Coverage

Insurance coverage differs from one employer to another. It is the responsibility of the parent to understand the limits of their insurance coverage for their child.

You will receive a statement for any unpaid co-pays, coinsurance, deductibles, or charges your insurance has pended because they need a response from you in order to process the claim.You are responsible for payment of your account within twenty-eight days from the date of the statement.

Please be aware that not all health insurance plans provide the same coverage for well and sick visits. For example, some insurance companies will cover the costs of a yearly physical, well baby exams, immunizations, x-rays, vision and hearing screens and others companies may not. You are ultimately responsible for the services provided to your child.

Billing Questions

We strive to ensure that all information is entered correctly. If you feel that an error has been made in your account please call our office and speak to the billing department. Payment may be made by credit card, debit card, or personal check.

A $50 charge will be added to your account for returned checks.

No Show Charges

Scheduled consultations or well visits cancelled with less than 24 hours notice will be charged a $45 fee; no show charges are not covered by insurance plans.

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