When visiting a doctor, it is always important to make sure the office accepts your insurance or you understand the steps you need to take to bill your own insurance.  At Pediatric Center of Round Rock, we always ask for insurance information. We accept all the different types of insurance carriers including Medicaid, but we want to make sure the visit and vaccines are going to be covered to avoid surprises.

What You Should Know About Your Insurance Coverage Before a Doctor Visit

  1. Call your insurance company to verify what is covered at a pediatric appointment. 
  2. Find out what labs in your area is covered by insurance if lab or radiology work is needed.
  3. Verify your out-of-pocket costs.
  4. Bring your insurance card to your appointment.

We encourage patients to become informed about the specific benefits of the insurance coverage they purchase, as it is impossible for us to know all details. As a courtesy, we do our part at verifying and discussing coverage with the carriers when accurate information is given to us in advance. We recommend that you always question your insurance company regarding your benefits and do not assume that everything done in the physician’s office is covered by your insurance. You can request specific benefit information from your insurance company before attending your appointment.

If we need to order outside labs or radiology exams, we provide insurance information to the lab and we discuss insurance coverage for specific tests.

Private pay patient charges must be paid in full at the time of visit. We offer a 20% discount on all of our services for patients without insurance, which is comparable to the typical insurance company contracted payment discount.

Please bring your insurance card to every office visit. We will ask for a copy of this card when you check in for your child’s appointment.

Are you adding a new baby to your family?

Your very first step should be to contact your insurance company to gain a complete understanding of the steps you will have to take. Most often, you will be required to call them within a few days of delivery to add your baby to your plan.

There are very important tests that need to be ran when you have a baby so that we can be sure that the baby is healthy and identify any problems. The average cost of medical care during the first month of life, including procedures done in the hospital can be well over $3,000. It is definitely in your best interest to find some assistance and ensure that your newborn is covered. If you aren’t covered, there may be options available to assist financially. Contact local officials, check out the CDC website and the United States Department of Family, Health and Child services, and see what options are available.

If you have questions about your bill, you can call our billing service at Medical Management Services at (512) 692-4915.

About the Author

Dr. Katalenas

Dr. Katalenas is a pediatrician and owner of The Pediatric Center of Round Rock and the author of the book "The Step Up Diet: From Scratch… The Quality, Quantity, and Timing Solution to Childhood Obesity", a guide to healthy cooking and eating for busy families.