Insurance We Accept

Sun Pediatrics participates with most insurance plans and accepts most PPO networks; however, we recommend that you call your insurance company to verify your participation as well as your benefits.  Call our office at (678) 501-5601 for more information, even if you do not see your insurance company on this list.  This list will not always be complete as changes with companies occur often.  The following is a list of most of the major insurance companies we are contracted with:

  • Aetna
  • Blue Cross Blue Shield
  • Beechstreet
  • Cigna
  • Coventry Healthcare
  • Humana
  • Lifewell
  • Medicaid
  • Medical Mutual
  • Multiplan
  • PHCS – PPO
  • United Healthcare

Financial Policies

Financial Policy

Thank you for choosing Sun Pediatrics. Our office is committed to providing the best possible treatment, as well as assisting you with insurance filing and payment of your account. In order to accomplish this, we have provided you with a financial policy.

INSURANCE COVERAGE

We accept most commercial insurance and Medicaid plans except Kaiser, Humana Connect plans, Humana HMO X, Tricare. If you are not certain whether we accept your insurance, please call your insurance carrier to inquire. It is your responsibility to understand the limitations of your insurance coverage.

You must present your child’s insurance card and a valid photo ID at every visit. We expect you to give complete and current demographic and insurance information for us to file the claim to your insurance carrier. If this information is incomplete or not updated, we will require payment in full of your charges on the day of the visit. There will be a $10.00 refiling fee if the correct information is not provided at the time of service. Copayments, outstanding balances from deductibles and coinsurances are due at time of service. A $ 25 billing fee will be assessed for failure to pay copayment at the time of service. As a courtesy to you, we will routinely file all claims with your insurance company. Some of the services we provide may not be covered by your insurance company, and you will be responsible for these charges. Disputed claims are contractual issues between you and your insurance carrier. If we are not contracted with your insurance carrier, or you are self-paying, your charges must be paid in full at the time of service.
New parents are required to notify their insurance plan of their newborn within first 30 days of birth. At the initial visit, we require you to sign a financial agreement to cover for the first visit. If your child is scheduled for a Well Child Exam or a Shot only appointment, but is experiencing symptoms that are addressed by the physician, you may be charged for a “sick” office visit. Depending on your insurance, you may be responsible for a copayment, coinsurance, and/or deductible. Payments for non covered or elective procedures are due at the time of service. If you receive a bill from outside laboratory, we ask that you contact to resolve any questions you may have.

PAYMENT OF SERVICES

We accept cash, credit cards (Visa and MasterCard), and debit cards. We do not accept personal checks.
Co-payments and other out-of-pocket expenses are due at check in. The adult accompanying the child to the appointment is responsible for co-payments.
There is a $ 10 charge for all camp, sports, and school forms that are not presented at the time of your child’s physical. This does not include (3231/3300 forms) for which there is no charge. Please allow 3-5 business days for completion of all forms.
There will be a $ 25 fee for missed appointments, or appointments not cancelled with at least 24-hour notice. The fee is not covered by your insurance company, and will be billed directly to you. Multiple missed appointments may lead to dismissal from the practice.
A copying fee of up to $ 15 per chart each time a copy of medical records is requested for any reason Patient with delinquent balances will not be permitted to schedule routine well exam appointments until the balance is paid in full.

Failure to pay balances within 90 days from the date of service can result in your account going to an outside collection agency. There will be a 25% fee added to your balance at that time.

In case of divorced or separated parents, the custodial parent is responsible for all copayments, deductibles, coinsurances, and any other out of pocket expenses.

BILLING INFORMATION

Please feel free to contact our billing department at (540)-665-2009 if you should have any questions regarding your bill.

Lab Work Policy

In the event that lab work is necessary, Sun Pediatrics will do our best to send specimens to the correct laboratory contracted with your insurance company. If for any reason your insurance company denies a laboratory claim due to laboratory incorrect billing, services not covered under your plan, insurance change, or specimen being sent to the wrong laboratory, Sun Pediatrics will not be liable for your laboratory charges/fees. 

Office Policies

At Sun Pediatrics, we are dedicated to making your experience smooth, comfortable, and efficient. We’ve prepared this section to help you learn more about our system and process. Questions? Just call (678) 501-5601.

New Patients

We look forward to taking care of your child’s wellness and acute care needs. To get started as a new patient with our practice, follow the steps outlined below:

Make an appointment

Appointments can be made Monday – Friday beginning at 8a.m. Please schedule your first visit by calling (678) 501-5601.
If you are expecting, we welcome you to make an appointment to meet with us before your due date.

Print and complete your forms

Save time by completing your forms before your visit! Please visit the patient forms section and download the New Patient Forms.

Get directions to our office

Visit our location page and get personalized driving directions to the office where your appointment is scheduled.

We look forward to seeing you!

Please remember to bring your insurance card and photo identification, and arrive 20 minutes early in order to complete any additional paperwork before your child sees the provider. Please present your completed forms to the receptionist upon your arrival.

Appointment Policies

Make an Appointment

Call us at (678) 501-5601. We offer same day appointments for most office visits. We recommend you schedule your child’s well-check visits in advance, however we will see your child as soon as our schedule allows. When scheduling an appointment, the receptionist will gather information to ensure enough time is allocated for your visit.

Arrive Early

Please arrive for your scheduled appointment 15 minutes early to allow time for the check-in process. If you are unable to keep an appointment, please call us at least 24 hours in advance so we may use those times for other patients.

Be Prepared

When making an appointment, please inform us of any changes in your address, insurance coverage, telephone number or emergency contacts. For first time patients, please provide the forms and information requested prior to your appointment. We request that new patients transfer their records to Sun Pediatrics prior to your appointment, if possible, so that we can most effectively treat your child.

Upon arrival, please sign in at the reception desk. You will be asked for your insurance card and driver’s license. You will also be asked to pay for the expected charges for the visit and any outstanding account balances.

A parent or legal guardian must accompany a minor patient unless prior written authorization is provided to us.

We do not allow walk-in and sibling add-on appointments. We offer same day sick appointments. Please call to schedule all appointments. It is unfair to our patients who have a scheduled appointment to ask them to wait while someone without a scheduled appointment is seen.

Please call to inform our staff if you are unable to arrive for your appointment on time. We will review the schedule to best accommodate your revised schedule needs. If you are more than 15 minutes late we may need to reschedule your appointment.

We follow the American Academy of Pediatrics Guidelines and recommend yearly “Well Examinations” for all patients over 3 years old. Younger children are expected to be seen at birth, 2 weeks, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, and 30 months.

Canceling an Appointment

If you are unable to keep an appointment, please call us as soon as possible (preferably at least 24 hours in advance) so we may use the time for other patients who need to be seen.

Prescriptions

Prescription Refills

For ongoing medications, Sun Pediatrics will submit prescription refills to your pharmacy. For chronic medical conditions please note that the patient needs to be seen and evaluated every three months for ongoing prescriptions. We must closely monitor children with chronic conditions, such as allergies, asthma, diabetes, etc. This allows continued evaluation and monitoring of their condition.

Prescription renewals are handled Monday-Friday, 8:30am-4:30pm. Please allow three business days to accommodate your request.

If your child’s prescription is running low, please do not wait until the weekend or until the medication has completey run out. If you are planning to travel out of town, please make sure your child has enough medication for the trip.

Antibiotics

While the prescription of antibiotics is appropriate and necessary in many cases, we prefer to be conservative in their use. Overuse can lead to serious problems, including infection from antibiotic resistant bacteria.

Antibiotics are only effective against bacterial infections, and provide no benefit to patients with viral infections such as the common cold or the flu. For this reason, Sun Pediatrics will not prescribe antibiotics without first examining the patient to determine the type of infection.

Payments

General

Co-pays are expected to be paid at the time of your visit.

The parent or legal guardian accompanying a minor to the office is responsible for full payment at the time of service. We cannot bill a third party (other than a contracted insurance company) or other parent if they are not present at the time of service.

For medical coverage with health plans we are contracted with

We will submit a claim for office visits, procedures, and hospital services provided by our physicians. You, the responsible party, will be required to make payment of your assigned co-payment or co-insurance at the time of service.

For medical coverage with health plans with which we are not contracted

Please understand that we will collect for the visit in full at the time of service and then you may be reimbursed by your insurance company based on your policy benefits. As a courtesy, we will submit your claims to the insurance company unless you choose to do so yourself.

Sun Pediatrics will not become involved in disputes between you and your insurance company, other than to supply factual information as necessary. You are responsible for any balance that your insurance company has not or will not pay. If your insurance company has not paid or denies benefits, please contact their claims department if there are any questions or complaints.

Your insurance company is the best resource for most billing questions. If you have not done so already, please call the number on your insurance card. If your insurance company cannot resolve the issue, please contact us at billing@sunpediatrics.com.

 

Make Your Appointment Today

Call (678) 501-5601