To Schedule An Appointment
NOE VALLEY PEDIATRICS
Call 415.641.1019
We are contracted with numerous insurance plans. Please contact the plan you are considering to confirm your Primary Care Physician is a contracted provider with that plan.
It is the responsibility of the patient and family to know and understand the policies and benefits of their insurance plan. This includes:
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COPAYMENTS
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COVERED HOSPITALS, LABS AND X-RAYS
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PRIOR AUTHORIZATION & REFERRAL PROCEDURES
We are a member of Brown and Toland Medical Group (BTMG). This is the only Health Maintenance Organization (HMO) group that we are contracted with. It is important that if you are a member of BTMG and receive care in our office that your child’s Primary Care Physician is assigned to one of the physicians in our office; Dr. Schwanke, Dr. Anne, Dr. Kaplan and Dr. Hurd.
Please add your baby to your insurance plan as soon as your child is born. Most insurance companies require that you add your newborn within 30 days of birth. If this is not done, your insurance carrier can refuse to add them to your plan.
Delay or refusal to cover your child can be very expensive for you. We have experienced delays and financial loss because of insurance eligibility problems.
Be prepared to show proof of current insurance. If you do not have proof of insurance, payment will be required at the time of service. If your plan requires a copayment, be prepared to pay the co-payment at each visit. There is a $10.00 administrative fee for failure to pay your co-pay at the time of service.
Please notify our office if there is a change in insurance coverage. Failure to do so results in unnecessary billings to companies only to find out that the policy has lapsed. Incorrect or outdated information will delay your claim and you may be held responsible for full payment.
Parents are able to get certain vaccinations at Noe Valley Pediatrics. However, we do not bill the parents insurance and payment is due at time of service. We will provide you with the necessary billing information to submit to your insurance carrier.
INSURANCE and BILLING INFORMATION
Should you have any questions regarding your insurance
Contact: Suzy in the billing department
OR
Well Child Visit Charges:
Many insurance plans require no copay or other out of pocket cost for routine well child examinations. However if in the course of that routine exam issues come up beyond the scope of routine health discussion such as significant dietary problems, school problems, chronic complaints about abdominal pain, allergy or headache it may require additional time for discussing these issues.
In those cases requiring extra physician time, an additional diagnosis and charge will be added proportionate to time spent. Adding that secondary diagnosis frequently triggers out of pocket costs such as copays and deductibles. An acute illness at the time of the well exam will also usually trigger additional billing and out of pocket expense. Here in our practice we are making sure that our billing reflects the care given during a visit.
A note about copays:
Please be aware that co-pays are due at the time of service. There will be a $10.00 administrative fee charged for any copays needing to be billed
We are contracted with numerous insurance plans. Please contact the plan you are considering to confirm Noe Valley Pediatrics is in-network with your plan. There are more and more narrow networks plans being offered that we are not considered in network providers for. Please verify our Tax id (45-1793779) and office location: 3700 24th Street, San Francisco, with your insurer to confirm our participation with your plan.
Please note: Noe Valley Pediatrics has only one office location: 3700 24th Street, San Francisco. We have found that some of the insurance carrier websites have incorrect provider directory listings.
It is the responsibility of the patient or family to know and understand the policies and benefits of their insurance plan. This includes:
-co-payments
-covered hospitals and laboratory
-Prior authorization and referral procedures
-in-network and out-of-network provider participation status
INSURANCE NETWORK
Notify our office if there is a change in insurance coverage. E-mail a copy of your new insurance card (both front and back) to NVP front desk. Failure to do so results in unnecessary billings to insurance companies only to find out that the policy has lapsed. Incorrect or outdated information will delay your claim and you may be held responsible for full payment.
UPDATE INSURANCE
IT IS VERY IMPORTANT TO NOTIFY YOUR INSURANCE CARRIER OF YOUR NEWBORN WITHIN THE FIRST 30 DAYS OF LIFE.
Most insurance companies require that you add your newborn within 30 days of birth. If this is not done, your insurance carrier can refuse to add them to your plan. At every office visit, be prepared to show your current insurance card and make your co-payment if your plan requires so. If your child is sent with a caregiver, please make sure that they are prepared to make the co-payment. There is a $10.00 administration fee for failure to pay your copay at the time of service.
HMO PLANS:
We are a member of Brown and Toland Medial Group (BTMG). This is the only Health Maintenance Group that we are contracted with. It is important that if you are a member of BTMG and receive care in our office, that your child’s Primary Care Physician is assigned to one of the physicians in our office. (Dr. Schwanke, Dr. Anne, Dr. Kaplan and Dr. Hurd)
COVERED CALIFORNIA:
Noe Valley Pediatrics participates in two Covered California SHOP (Small Business Health Options Program) offered by Blue Shield and Health Net. These are small group plans, not Individual Family Plans.
INDIVIDUAL FAMILY PLANS:
Noe Valley Pediatrics does not participate in the Individual Family Plans offered by Blue Shield and Anthem Blue Cross. (On or off exchange).
The two Individual Family Plans that Noe Valley Pediatrics participates with are:
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Health Net PPO and Cigna Local Plus.
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Please contact your member services to verify if our practice is participating in your plan and to verify your benefits.
Medi-Cal:
Noe Valley Pediatrics participates only in the Blue Cross Managed Care Medi-cal plan. Parents are able to get certain vaccinations at Noe Valley Pediatrics. However, we do not bill the parents insurance and payment is due at the time of service. An itemized billing receipt will be provided to you to submit to your insurance carrier.