Billing & Insurance
Our billing team does their best to make insurance claims as painless as possible.
Health Insurance
We bill participating insurance companies for you, including secondary insurance.
Insurance Cards
Please bring your child’s current insurance card with you to each visit. This helps ensure that the proper information is processed, and the appropriate insurance is billed for that day’s visit.
Co-pays & Deductibles
Depending on your insurance policy, a copayment and/or deductible may be required at the time of service. Payment may be made in cash, in-state personal check, Visa, Mastercard, Discover, American Express, or Apple Pay.
A service fee of $10 will be charged if we do not receive your co-payment within 5 days of the visit. If we have not received payment from your insurance company within 45 days of the date of service, you will be expected to pay the balance in full.
Medication cost is a challenging reality for many, and medication coverage often changes. If a recommended treatment is too expensive and/or not covered, call our office and we can check whether there are suitable treatment alternatives.
Plan Changes
If your insurance plan or carrier changes, it is your responsibility to notify our office. If our office is not notified of insurance changes within 30 days of filing a claim, the account holder will be held responsible for the charge.
Denied Claims
Claims denied by insurance companies will be billed to the responsible party.
Accepted Insurance Plans
- To make our practice accessible to all families in the community, we participate in a variety of insurance plans, including VT Medicaid.
- Aetna, First Health Networks
- Blue Cross/Blue Shield
- CBA Blue
- Cigna
- MVP Health Care
- North American Preferred
- Tricare
- Vermont Medicaid
- United Healthcare
There are a few insurance companies with whom we do not participate. For these companies, full payment from you is expected at the time of service. Your time of service receipt includes all information necessary for submitting claims to your insurance company.
Tips for New Patients
To ensure you maximize the benefits provided by your insurance company, we suggest you take the following steps:
- Call the member services number on your health insurance card. Tell the insurance company the name of your child’s Essex Pediatrics doctor. If you have just had a baby, call your insurance company immediately to add your infant to your policy.
- Ask the insurance company or your employer human resource department to review the terms of your insurance contract. Some insurance plans have large deductibles and little or no well child coverage. Ask your insurance carrier the following questions:
- Do I have a deductible?
- Is well child care covered by my insurance?
- Are immunizations covered by my insurance?
- How many checkups are covered per year?
- What is my copay and is it required for all visits?
- What is your policy coverage for Emergency Room care?
- Follow up with your insurance company 2–3 weeks after you sign your contract or enroll a new child to your plan to verify they have correctly recorded your child’s new doctor.
Secure & Convenient Online Payments
Essex Pediatrics works with industry-leader Payment Pros to enable our patients to safely and securely pay their bill online through our website or through your patient portal.
In addition to paying your Essex Pediatrics statements online, you have the option of registering for an account. This provides:
- Convenience & Security
Securely save your payment information on file for future use - Keep track of payments
View your payment history and print receipts at any time
Financial Policies
Essex Pediatrics is dedicated to providing you with the best possible care and service. Your clear understanding of your financial responsibilities as an essential element of your children’s care.
Unless other arrangements have been made in advance by either you or your health coverage provider, full payment is due at the time of service.
We understand there are times when extenuating circumstances cause financial hardship. If this occurs, please contact our billing office to discuss a payment plan.
- Essex Pediatrics accepts cash, in-state personal checks, Visa, Mastercard, Discover, American Express, and Apple Pay.
- There is a service charge of $20 for returned checks.
- There is a $7 fee for each bill sent after the initial statement.
- All fees from our collection agency for overdue account balances will be your responsibility.
- Any account sent to our collection agency for lack of payment may be dismissed from our practice.
- Inquiries regarding charges for procedures are the responsibility of the patient / parent.
- The expense for services provided is the responsibility of the legal guardian escorting the child, regardless of existing legal arrangements. Except in limited circumstances, such as in the case of an emancipated minor, all legal guardians are financially responsible for their children’s care.
- Refunds: Upon written request within 30 days, overpayments will be refunded to the responsible party.