Billing and Insurance

Billing Office

Voice: (314)392-4258
Fax: (314) 878-6987
Email: billing@stlpeds.com
Monday Ė Friday 8:00 am to 4:30 pm

Payment

We accept the following forms of payment:

  • Cash
  • Master Card
  • Personal check
  • American Express
  • Visa
  • Discover

Online bill pay coming soon. Please call our billing office (314) 392-4258 to pay over the phone by credit card.

Insurance

Please be familiar with your insurance plan. It is the parentís responsibility to be informed about your child's insurance coverage/benefits for sick visits, well visits, labs, radiology and prescriptions. St Louis Pediatric Associates, Inc. cannot take responsibility for knowing all of the insurance plans and variances in coverage/benefits. While we accept most major insurance plans, we are not on all plans. You are responsible for all charges that you incur if yours is an insurance that we do not accept. If we do file with your insurance, you are still responsible for your co-pay, deductible, and any charges that your insurance denies. Your insurance will periodically change the emergency rooms, urgent care facilities, hospitals, labs, and radiology facilities that they approve for your use. Please keep abreast of these changes for your plan so that you know which facilities will be covered. If your child is sent to an urgent care center or emergency room by one of our physicians and your insurance requires pre-authorization for such a visit, it is your responsibility to contact our insurance department during the NEXT business day. Our staff will be happy to help arrange for the insurance authorization.

We participate in many healthcare plans, but it is the parent's responsibility to check with their individual plan to make sure we are participating providers

  • Aetna
  • Anthem BCBS (Blue Access/Access Choice) ---we are not Blue Preferred providers
  • Beech Street PPO
  • Cigna HMO & PPO
  • Coventry - First HealthóNational Network
  • Great West
  • GHP/CMR---we are not PPO Select providers
  • Healthlink HMO & PPO
  • Humana Choice Care Network
  • PHCS
  • UHC

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Copayments

All copayments are due at time of service.

There is a $25 service charge for not paying copay at time of service. The fee will be waived if payment is received before close of business on the day the services are provided.

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Billing and Insurance Frequently Asked Questions

1. Do you take my insurance?

We are participating providers for many networks (see billing page for complete list). However, there are some plans within the networks that we do not participate in. We can verify if we participate in a network but we are not able to verify if we are covered by an individual plan within the network. It is the patient and/or guardians responsibility to determine if we are participating in the individual plan.

2. Are vaccines covered by my insurance?

We cannot know what is covered under every individual insurance plan. It is your responsibility to know what is covered under your specific plan.

3. How was I supposed to know this was not going to be covered?

Please be familiar with your insurance plan. Procedures are billed as separate charges to your insurance company. You are responsible for your co-pay, deductible, and any charges that your insurance denies. Your insurance will periodically change the emergency rooms, urgent care facilities, hospitals, labs, and radiology facilities that they approve for your use. Please keep abreast of these changes for your plan so that you know which facilities will be covered.

4. Why should I call my insurance company before scheduling a yearly physical?

Some insurances pay for physicals once a calendar year, meaning you can schedule one time anytime between January and December. Some insurance companies will pay for a physical once every 365 days. It is important to know which type of coverage you have before scheduling your physical in order to ensure the appointment will be properly covered.

5. Do I have to pay a copayment if I see the nurse?

Yes, a copayment is due at every office visit. This is a contract between you and your insurance company. We do not collect a copayment at the time of service for vaccine only visits scheduled with a nurse because some insurance companies do not require a copayment for that type of service. You will receive a statement from us if your insurance company determines a copayment is due.

6. We are divorced. Can you bill my ex?

The bill will always be sent to the address of the parent who signs the Financial Policy each year.. It is that parentís responsibility to pay the bill by the date it is due.

7. Can you bill me for my copayment?

Copayments are due at time of service. It is the responsibility of the person bringing the child to the office to pay the copayment. If we have to bill you for the copayment there is an additional charge of $25 added to the account. This fee will be waived if the payment is called in before 4:30 pm on the date of the office visit.

8. Why donít you have my credit card on file?

We do not keep credit card numbers on file. You can call our billing office at 314-392-4258 to make a credit card payment by phone from 8:00 am to 4:30 pm Monday through Friday.

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