Tuesday, January 29, 2008


Pediatric Health Associates is very much aware of the high cost of insurance and the dwindling benefits that are offered to you. IT IS VERY IMPORTANT THAT YOU FOLLOW THESE GUIDELINES, when scheduling a well child appointment.

1) Read your benefits manual. This should explain in detail how much coverage your child has for this type of service. If you are not clear on the facts noted in the summary of benefits, CALL YOUR INSURANCE COMPANY. They can explain all of these items.

2) Keep your information in a file that is readily available. Document all calls, with date and name of person you contacted.

3) Your explanation of benefits will be mailed directly to you. Read these and again, if you have any questions, contact your insurance company

4) Communicate with our staff that you are aware of the amount of well coverage for your child. It will be easier on you and us, if we know from the beginning what type of coverage you have.

5) If your claim is denied and you don’t agree with that decision, call your insurance company. Very often a phone call is all that will be needed. If you are not satisfied with the outcome, write an appeal letter.

6) Remember: it is your responsibility to get your insurance company to pay your claim. We will help in any way we can, but the initiative needs to come from you.

Peggy - Accounts Receivable Manager