Insurance & Billing
We are committed to providing and maintaining the best possible care for our patients. Integrity Health Group provides equal access to all of its patients regardless of source of payment. Your review of our office financial policy in advance allows for good communication and enables us to provide the highest quality service to your family.
At the time of each appointment, please provide your insurance card, current mailing address and copayment/coinsurance. If you have any questions or concerns, please contact our Billing Supervisor, Mary Devantier at (716) 691-3400 extension 204.
Payments Due at Time of Service
Office services are payable at the time of service unless prior arrangements have been made with our office. This is an insurance company policy, which includes all applicable copayments or coinsurance from participating insurance companies. We accept cash, checks, debit cards, MasterCard, Visa, Discover, and American Express.
We participate with numerous Insurance companies including local HMO plans. If your plan requires, you must choose one of our providers at one of our four locations as your primary care physician. To prevent billing concerns you must do so prior to your first appointment. Please be aware that some insurance companies do not pay the entire doctor’s bill, therefore you may be responsible for the bill.
Non-Participating Insurance Companies
If we do not participate with your insurance, we will submit claims on your behalf as a courtesy. If your insurance company does not pay within 45 days, you will be responsible for the balance.
Copayments & Deductibles
During a visit to our office, patients may receive several different kinds of services; each service may have a separate charge. By addressing new or established issues during a preventive care exam or “Check up”, we hope to avoid any inconvenience or additional visits. Your insurance company may require that you pay a copayment, coinsurance or deductible for these services. This is due at the time of the appointment.
In the event that your health insurance company determines a service is "not covered", you will be responsible for the complete charge. Should this occur, we will personally bill you for the services. Payment is due upon receipt of that statement.
Please determine in advance if your insurance plan completely covers immunizations. We participate in the Vaccines for Children (VFC) program, which provides immunizations for children at no cost to you. If your insurance plan does not cover immunizations or you have no insurance coverage, you will be responsible for the vaccine administration fee.
Medicaid and Medicaid Managed Care
We participate with NYS Medicaid and Medicaid Managed Care insurance plans. If you are required by Medicaid to select a managed care plan, please make sure you inform our office of your selection.
NYS Child Health Plus and NYS Essential Plan
These programs may be available for patients who are ineligible for Medicaid. The office staff will be glad to help guide you to the resources to apply.
Workers’ Compensation and No Fault
If you have sustained injuries in a work-related or motor vehicle accident, please notify us at the time of your appointment. All No-Fault and Workers’ Compensation information should be given to us at the time of first treatment. By law, No-Fault claims must be filed by you within 45 days. Tonawanda Pediatrics does not bill your No-Fault insurance directly. You will receive a bill for services rendered and are responsible for payment to Tonawanda Pediatrics. You are responsible for submitting to your No-Fault insurance carrier for reimbursement to yourself. In the case of a Workers' Compensation accident, please notify your employer of the injury.
Please note that all patients under the age of 18 require parental consent for any treatment or immunization except as permitted by New York State law and must be accompanied by parent/guardian. The parent/guardian accompanying the minor patient will be responsible for payment of all services rendered, whether the account is considered self-pay, participating insurance, or non-participating insurance. Our concern is for your child’s growth and development. Tonawanda Pediatrics will comply with all binding custodial legal agreements.
Past Due Accounts
An account is considered past due if no payment is received within 30 days of the first account statement. Patients with past due accounts must make a payment before the next appointment with their health care provider. A statement fee of $5.00 will be added to each month after the first statement. An interest charge of 1.5% per month will be added to all accounts over 30 days past due. Accounts that remain delinquent will be forwarded to a collection agency. A $10 fee will be assessed on all accounts that are sent to a collection agency.
If you are unable to make full payment of the account balance when due, arrangements for a partial payment plan can be made with the Billing Supervisor, Mary Devantier. Note: There is a $5.00 per statement fee on delinquent accounts. She can be reached at (716) 691-3400 extension 204. She may also be reached via email: email@example.com
Insufficient Funds Checks
Returned checks will be charged back to the patient's account. There will be an additional $40.00 service fee for each returned check. We reserve the right to require cash or credit card for future payment on accounts with frequently returned checks.
Our insurance and patient billing is handled by HealthTec Solutions. The staff at HealthTec Solutions works very closely with Tonawanda Pediatrics, Island Pediatrics and Transit Meadow Pediatrics to ensure that your insurance is billed properly and that full reimbursement is received from your insurance company. For any questions regarding your account, please call HealthTec Solutions’ staff at 716-639-0155 Monday through Friday 8:00 am through 5:00 pm.
A missed appointment prevents our practice from providing care to other patients. Appointments canceled or rescheduled prior to the appointment are not subject to a fee. Patients who have missed their appointments without notifying us will have a $50.00 fee applied to their account.