Insurance & Billing

Please read this helpful information about our insurance and payment policies.

Please contact our billing office at 716-691-3400, ext. 203 or call your insurance carrier should you have questions.

Payments Are Due At Time Of Service

All office visits are payable at the time of service unless prior arrangements have been made with our office. We accept cash, checks, most major credit cards and debit cards. Payments can also be made on the website.

The insurance carrier you have selected may require that you pay a co-payment or deductible at the time of service. Please be prepared to pay when you are seen by one of our providers.

Tips For New Insurance

• We will ask you to verify your insurance coverage.
• Make sure that new insurance cards are correct. Check all names and numbers closely. Call your insurance company if anything is incorrect. Make any corrections before coming to our office to avoid any insurance rejections.
• Please show us any new insurance cards you have when you come to the office.
• Tell your insurance company about any newborns. As soon as possible after a baby is born, you should notify your insurance company. Also, notify your employer and ask them to be sure the baby's coverage starts on the date of birth.

Non-Participating Insurance Companies

We participate with most insurance carriers including Medicaid, Medicaid managed care, Child Health Plus and Family Health Plus program. If we do not participate with you insurance company, we will submit claims for you as a courtesy. If the insurance company does not pay within 45 days, you will be responsible for payment of all charges.

Non Covered Services

In the event that your health insurance plan determines a service to be "not covered", you will be responsible for the complete charge. Should this occur, we will bill you; and payment is due upon receipt of that statement.

Find out if your insurance plan covers immunizations 100%.  If your insurance plan does not cover immunizations completely, we participate in the Vaccines For Children (VFC) program that provides immunizations to children at no cost to you.

Medicaid And Medicaid Managed Care

We participate with NYS Medicaid and the Medicaid Managed Care plans. If you are required by Medicaid to select a primary managed care plan, please make sure to select one of the plans listed and inform our office of you selection.

New York State Child Health Plus

Any uninsured child that is not eligible for Medicaid automatically qualifies for New York State's Child Health Plus. The office staff will be glad to provide you with an application form.

Workers' Compensation And No-Fault

If you have sustained injuries in a work-related or motor vehicle accident, notify us when you check in. All no-fault and compensation information should be given to us at the time you are first treated for the accident. No fault claims must be filed within 45 days by law. Failure to supply us with this information will result in your being responsible for payment. In the case of a Workers' Compensation accident, you employer must be notified of the injury.

Minor Patients

For all services rendered to minor patients, the adult accompanying the patient to the office is responsible for payment. In the case of divorced or separated parents, we will not become involved in your legal agreements.

Past Due Accounts

An account is considered past due if no payment is received within 30 days of the initial billing date. Patients with past due accounts must make a payment before being seen by your health care provider. 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.

Payment Arrangements

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 Office Manager.

Insufficient Fund Checks

Returned checks will be charged back to the patient's account. There will be an additional $20.00 service fee for each returned check. Future balances must be paid by cash or credit.

Billing Company

The insurance and patient billing are performed by HealthTec Solutions. The staff at HealthTec work very closely with Tonawanda and Island Pediatrics to ensure that your insurance is billed properly and that full reimbursement is received. For any questions regarding a bill you receive, call HealthTec staff at 716-639-0155 Monday through Friday.

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