Separated / Divorced Families

Effective: April 2, 2009

1. For those families where parents are separated or divorced, the parent authorizing treatment by bringing the child to be seen is responsible to us for payment. All payments are due when the service is rendered.
2. In the case of contracted insurance only, copay is due at the time services are rendered. Subsequently, all charges deemed parent responsibility by the contracted insurer are due to Carmel Pediatrics by the parent who authorized treatment.
3. If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent’s responsibility to collect from the other parent. Carmel Pediatrics will refrain from acting as a mediator in collecting our payments.
4. A copy of the bill with appropriate insurance coding will be given to the authorizing parent at each visit.
5. If the account is not resolved in a timely manner, the authorizing parent’s information will be submitted to our collection agency.
6. Non-compliance with this policy may result in transfer of care to another practice.