Dr. Trover | Important Policies

Accepted Insurance Plans

We participate wih most major insurance plans, including Blue Cross Blue Shield, United Healthcare, Cigna, and Aetna. We are also in network for all Georgia Medicaid and PeachCare patients. We are accepting new patients for most of these plans.

Appointment Attendance

We try hard to see your child promptly at their appointment time. Particularly in seasons of heavy illness, (fall and winter) our schedules are very full and there is little or no space to accept additional appointments.

We understand that delays can occur. We allow a 15 minute window of time for you to arrive after your scheduled appointment time. After 15 minutes, your appointment is removed from the schedule so other patients are not delayed in being seen. You will be asked to reschedule your appointment if you do arrive more than 15 minutes after your appointment time. School notes are not given for non-attended appointments.

Frequent or repeated non-attendance/non-cancellation is considered cause for patient dismissal.

Financial Policy

We find that communication with our patient families about our financial policy assists us in providing the most effective service. We have therefore provided answers to the most commonly raised issues. We thank you for entrusting us with your child’s care.

Current Coverage and Patient Information – Federal Law FACTA, effective 8/1/09 for healthcare, includes the "Red Flag Alert" requirement designed to reduce medical and insurance identity theft. We are now required to identify you and confirm the ownership of the insurance we are asked to file for your visit. For this reason please be prepared to present your child’s insurance card at each visit. You are responsible to promptly notify us of any change in your insurance coverage or your contact information. If we are unable to file a valid insurance claim, or if we exceed insurance company limits for timeliness of filing because we were unable to reach you or because you did not provide prompt notice of your child’s insurance information, responsibility for payment of the uninsured charges will be assigned to you with payment due in full upon receipt of your statement. State funded insurance (Medicaid or Peach Care) must be used as insurance of last resort, and cannot be used electively instead of other active insurance your child may have.

Insurance Eligibility - Our office staff verifies insurance eligibility the day before or the day of your appointment. If we cannot confirm active coverage for your child, we will ask that you pay for that day’s visit. If you wish, we will still submit a claim on your behalf to the insurance of record, and if the carrier pays the claim, we will then refund any overpayment on your account to you. Medicaid/Peach care eligibility letters from the Dept. of Social Services are not accepted as proof of current active coverage status.

Regarding Insurance - Dr. Trover’s services are provided to your child and not to your insurance company. Thus, you are expected to pay your co-payment at check-in on the date of service. If your deductible is unmet for the calendar year, we may ask you to pay a portion of your deductible at the time of service if the day’s charges are expected to be significant (>$100.00.) As a courtesy, we help our families by filing claims directly with their insurance companies. If your insurer fails to pay a correctly filed claim within 45 days, we will look to you to pay the balance on your account. You may then seek reimbursement from your insurance company. We will provide documentation needed, though the claim will normally be in the company’s possession.

Remainder/Unpaid Account Balances assigned to you for payment – Account balances assigned to you will be maintained for a maximum of two additional statement cycles. After that time, balances for which no acceptable arrangement has been made or honored will be placed with an agency for collection and credit reporting. If your account is sent to collection, most often your child (ren) will be dismissed from care with written notice and additional limited availability of Dr. Trover’s services for 30 days to allow you to select another physician. Collection accounts, even after payment in full, will be updated to “paid collection account” status. Prior delinquency status is not removed from credit reporting unless the account was reported by us in error.

Uninsured Patients – Self-pay patients are expected to pay charges on the date of service. We collect estimated charges for the visit at check in. Additional fees for any needed lab tests, injections etc., are collected at check out. We offer a prompt pay discount on the visit portion of self pay charges to align the cost of services with payments we receive for insured patients. The discount is only available for same day payment and may not be applied to payment plans, deductibles, co-pays, or co-insurance.

Payment Plans – If you have at least a one year relationship and payment history with this practice, a payment plan may be available to help you pay large balances (>$100.00.) Payment plans should be requested and approved in advance of scheduling services. Our plan format for large balances is 50% of total charges at the time of service, with payment of the remaining balance in equal monthly or bi-weekly installments in no more than 90 days.

Payment Plan Default – A payment plan is already an extension of credit. We will consider your plan in default 10 days after the first missed payment. We will make one telephone attempt to bring the account up-to-date. Multiple statements will not be mailed on delinquent payment plans. Accounts in default may be immediately sent to our collection agency without further contact.

Payment Forms Accepted – We accept, cash, imprinted personal checks from local banks, Visa/MasterCard Debit cards, Visa, MasterCard, Discover and American Express credit cards. More than one NSF check on a guarantor’s account will disallow future payment by check.

NSF Checks - IF YOU WRITE CHECKS TO THIS PRACTICE, PLEASE READ THIS SECTION CAREFULLY. Due to increasing NSF check losses, this practice has enrolled with a check recovery service through our bank. This service collects checks that are returned unpaid by the check writer’s bank. The state allows a fee to be charged to your account for this process. This fee is in addition to NSF fees charged by your bank and/or fees charged back to you by us to recover returned deposit item fees. State allowable fees are the greater of $30.00 or 5% of the check amount. We want to make certain that you are aware of our use of this service. This service will have no impact on patients whose checks clear in the normal course of business.

We will no longer accept personal or business checks for payment of copays and over the counter payments after two NSF returned checks.

If you need clarification of any of these policies, please call our office and request to speak with either our Billing and Insurance Representative or the Practice Manager. We appreciate your prompt payment of amounts due. It allows us to continue to provide quality care and full access to immunizations for your child.

Revised 10/28/2010