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Billing & Insurance

Bear Pond Family Medicine & Pediatrics follows and agrees with the American Academy of Pediatrics and American Academy of Family Physicians recommendations that you as a patient receive regularly scheduled well visits and routine follow ups for any chronic conditions.

Due to the new and continuing changes in health insurance, our billing department has had many phone calls from patients questioning their bills and charges. Please review the following information to educate you and your family on what to expect at your visit.

Know your insurance plan

Between health savings accounts and high deductible plans, you need to check your benefits to see what is — and is not — covered:

  • Does your plan cover well care visits?
  • Does it cover well care visits 100%?
  • Are there restrictions to vaccine coverage?
  • Does your plan cover sick and follow up visits?
  • What is your copay and deductible?

Please call the number on the back of your card to verify if we are in network with your plan. If you have any changes to your insurance policy, please let us know and provide updated information as soon as possible.

Insurance Providers

Bear Pond Family Medicine & Pediatrics is contracted with the following insurance companies and we agree to file claims on your behalf with these companies.

In order to file correctly to your insurance company, you MUST bring the newest copy of your insurance card to EVERY visit. If we are not contracted with an insurance, we will not file with that insurance. You will have to be self-pay for any visits, and we will send you a claim you can file for reimbursement with your insurance.

NOTE: At this time, we are accepting Medicaid patients under the age of 19 only.

insurance providers

We accept some of the following plans for
Health New England

For patients under 19, we accept
Husky Health

We accept, but are out-of-network* for
Tricare

*Costs may be higher than seeing an in-network provider.

Newborns

We ask that you add your newborn to your insurance plan within 30 days of birth. Bear Pond Family Medicine & Pediatrics follows the AAP guidelines, which recommend that your baby is seen within 48 hours of being discharged from the hospital.

This visit is considered a “well visit” and is most often covered by insurance as a well visit. We then see newborns back in a week for a weight check, to make sure they are feeding okay and gaining weight properly. These visits are considered a follow-up and your copay or deductible will be applied.

NOTE: Please make sure you add your newborn to your insurance plan as soon as possible. It MUST be done within 30 days.

Charges

  • We charge for all services/procedures performed by our providers.
  • We do not currently charge for after hours triage calls.
  • Please be aware, if any outside labs or radiology is required, you will receive a separate bill from those facilities.
  • Our cancellation policy is 24 hours prior to appointment time.
  • No-show fees: $25 will be charged for an office visit and $50 will be charged for a physical.

If you are here for a physical appointment, please read in full:

A preventive service does not deal with new or existing problems. Occasionally, a provider will learn of a new or worsened patient condition during a scheduled preventive (physical) visit. If you discuss specific problems that require immediate attention and an additional workup, beyond that usually associated with the preventive service, an office visit charge will be applied for a problem-focused service in addition to the preventive service. Separate services require separate billing. Per your contract with your insurance company, it may generate and extra charge for copay, coinsurance, or deductible for the office visit charges.

Please read and understand that a preventive exam is not intended to discuss acute problems, chronic conditions, or to request medication refills. Understand that if you must address non-preventive medical problems with your primary care provider, you will be billed for the services rendered.

Thank you for understanding.

Payments

  • Payment is expected in full at the time of service unless the service is covered 100% by insurance. Failure to pay can results in the rescheduling of your appointment.
  • If you are self-pay, payment is due at the time of service.
  • Co-pays are due at the time of service (Please remember we do not set your co-pay amount. Your co-pay amount is contracted between you and your insurance carrier, we are not allowed to waive co-pays).
  • In the case of divorce or separation, the parent authorizing treatment for the child will be responsible for all charges. Note: Please have the child’s insurance information, even if you are not the holder of the policy.
  • Make sure you know your plan and what it will cover, so you are aware of payment responsibilities of charges not covered by your insurance.
  • For Health Savings accounts, payment is expected within 30 days after insurance has processed your claim.
  • Self-pay fees are due at the time of service.

If you need to discuss a payment plan please call 860-714-7362.