We accept most insurances, but do encourage you to verify that we are a Participating Provider before your visit. Always bring your insurance card with you. Copay is expected at the time of the visit. If you do not have insurance or if your insurance does not cover office visits and immunizations, a payment plan can be set up according to need. This is done for your convenience but ultimately any balances are your responsibility. We accept payment by Discover, Visa and MasterCard. Insurance questions or concerns may be directed to our Accounts Receivable staff by calling 301.393.2600 and selecting option 4.
Insurance & Fees
The following is the list of insurances with which we participate. This will be updated from time to time as needed:
- Aetna Better Health Maryland
- Aetna Commercial/Medicare
- Amerigroup MD
- Anthem BCBS
- CareFirst BCBS
- Cigna Healthcare
- HealthNet Federal Services (HNFS) Tricare
- Humana Military Tricare
- Maryland Medicaid
- Maryland Physicians Care
- Medicare – MD – Novitas
- Medicare – MD – Novitas – Rest of State
- United Healthcare
- United Healthcare Community Plan – Maryland
- WebTPA – Custom Ink
*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.
Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.
We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.
We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.
At check-in we will:
- scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card
After your insurance has paid their portion, we will:
- notify you via email of the balance owed
- charge the balance owed to your card on file
- email a receipt for the charge
Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).
Full payment, including deductibles and copays, are expected at the time of service unless you have made arrangements in advance with our business office. Failure to pay a copay at the time of service may result in a $10.00 fee. The office accepts cash, personal checks, and the following credit cards: Discover, Visa and MasterCard. Please present your child’s insurance card at each visit to help us to submit claims to your insurance company correctly. We make a reasonable effort to submit claims to all health insurance companies. As a courtesy to our patients, we also submit to those insurance companies that we are not contracted with but payment in full is expected at time of service. The person who brings the child in for treatment is expected to pay the copay and/or deductible unless arrangements are made in advance.
Missed Appointments/Late Cancellations
Missed appointments are costly to us, to you, and to other patients who could have used the time set aside for your child. Please call at least 24 hours in advance to make scheduling changes and to avoid the $50 missed appointment fee. Repeatedly missing or cancelling appointments without adequate notice may result in discharge from the practice.
Additional Fees at Checkup
These appointments are preventative visits. This includes a very specific list of what may be done or discussed. If the visit does beyond that list, the visit is subject to deductibles and/or copays. This occurs when a medical problems is discussed requiring extra time for medical decision making such as diagnostics or treatment. This is called a modifier 25 for insurance purposes.(Go towww.medicareinteractive.org, click on “What Medicare Covers“, then “Preventative Care Services” and then “Welcome to Medicare Preventative Visit” to see what is covered.)
Routine forms such as those for daycare, sports or school are $5.00. The fee to complete FMLA forms is $10.00. All other forms are charged at the practitioner’s discretion. Fee must be paid prior to receiving the form.
Your insurance may not cover every type of service that we provide (travel vaccines, vision/hearing screens, and/or ASQ developmental assessment questionnaires.) Some well visits may not be covered depending on your insurance coverage and the timing of the well visit. Fees should be paid at the time of service.
After Hours Services
In order to compensate and encourage doctors to provide after hours and weekend visits, The State of Maryland states practices can charge and be reimbursed for “after hours” services. The after-hours are between 6pm and 8am, Monday through Friday or on weekends/holidays. The additional cost of $25 may or may not be covered by your insurance plan. The after-hours code is 99050. For more information on the after-hours code, you may go to Maryland Health Commission website.
Any charges that remain unpaid after 30 days after the date of service are considered past due. If no effort is made to pay the balance due, the bill may be sent to our collections process. In this case, the family may be discharged from the practice and the parents asked to seek medical care for their child/children elsewhere. If an account is assigned to a collection agency, the parent agrees to pay all collection agency fees, court costs and attorney fees.
We will not see patients for routine exams/well visits, evaluations or follow-ups if a patient’s account is in collections.
Return Check Fees
There is a $30.00 charge for any check returned unpaid to us from the bank.
How to Contact Us
If you have questions, our biller can be reached at 301.393.2600, option 4 between the hours of 8:00 am-4:00 pm, Monday through Friday. Please read and understand our financial policies. Keep us informed of your child’s insurance status and any changes in your address and telephone number(s).
REMEMBER- IT IS YOUR RESPONSIBILITY TO KNOW WHAT YOUR INSURANCE PLAN COVERS AND DOES NOT COVER. THE BILL IS ULTIMATELY YOUR RESPONSIBILITY TO PAY.
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