Financial Policy

Thank you for choosing BYP Kids to meet your child(ren)’s health care needs. We are committed to providing the best care possible and appreciate your trust. Please understand that payment of your bill is considered part of your child(ren)’s treatment. The following document is our Financial Policy. Please read it carefully; we will require that you agree to and sign this Policy prior to receiving treatment.

RESPONSIBLE PARTY

BYP Kids will gladly submit claims to your health insurance for the services provided. However, any charges accrued on the account are your responsibility. You will be expected to follow up on any unpaid or incorrectly paid charges, regardless of insurance coverage. We will be happy to assist you in any way we can, but you are ultimately responsible for timely payment of your account.

In divorce situations, the person bringing the child into the office is the responsible party. A divorce decree is a document that involves you, your ex-spouse and the courts. Although a divorce decree may state that an ex-spouse is responsible for medical bills, Brickyard Pediatrics has no authority to enforce compliance.

You will be responsible for the charges accrued by minor children (under age 18) who come into the office unaccompanied, or in the presence of another caregiver (ie. grandparents, baby-sitter, etc.).

You will be responsible for charges accrued by children who have turned 18 until such time as you notify BRICKYARD PEDIATRICS in writing, prior to services being provided, that you no longer accept financial responsibility. 

BILLABLE SERVICES 

BYP Kids will charge for physician services, as well as supplies used for the care of your children.

BYP Kids will charge for all follow-up services. The same resources (staff, room, supplies, physician time, etc.) are used for the follow-up visit, so the charges will usually be the same as the initial visit.

BYP Kids will charge for all scheduled, walk-in and after hour appointments. We will also charge for patients who are not scheduled (ie. siblings of a scheduled patient) that the physician is asked to see.

Occasionally a patient will be scheduled for one type of service but the physician may diagnose and treat another problem in addition to the scheduled service. When appropriate BRICKYARD PEDIATRICS will charge for the additional service. Some insurance companies will not cover both services, which may result in a denial or higher co-pay.

BYP Kids reserves the right to charge for extensive phone calls, reporting, consultation, coordination of care with other providers and/or other services provided on your child(ren)’s behalf. Your insurance may not cover these services.

BYP Kids reserves the right to charge for missed appointments when said appointment has been confirmed, including same-day appointments. These charges will not be billed to your insurance company but will be your responsibility. 

PORTION DUE AT TIME OF SERVICE 

If you have insurance coverage, all co-pays, co-insurance and deductibles are due at the time of service.

Payment in full is due from self-pay patients at the time of service. A 30% adjustment will be given when charges are paid in full on the date of service.

Payment in full is due at the time of service from non-BYP Kids patients (tourists, etc.), regardless of insurance coverage.

Payment in full is due at the time of service from accounts with a “bankruptcy” status.

BYP Kidsreserves the right to charge a “re-billing” fee for amounts that are due, but not paid, at the time of service. 

METHOD OF PAYMENT 

BYP Kidsaccepts the following types of payments:

Check (including cashier’s checks and money orders. No third-party checks)

Cash

Visa, Mastercard, Discover and American Express credit cards

INSURANCE COVERAGE 

It is your responsibility to provide accurate insurance information to BYP Kids at the time of service.

BYP Kids will create and submit claims to your health insurance on your behalf. However, we reserve the right to refuse insurance and collect payment in full from you (ie. out-of-state Medicaid, insurance information provided after claim filing deadlines, etc.).

BYP Kidswill not submit claims directly to an auto insurance carrier. We will provide you with the claim form, and you will be responsible to submit the claim to the appropriate no-fault carrier.

It is your responsibility to verify that the doctor you have chosen is a participating provider under your insurance plan, prior to receiving services.

It is your responsibility to verify benefits under your plan. You will be responsible for any non-covered services and services considered to be over “usual, reasonable and customary (URC)”. You will also be responsible for amounts not paid by your insurance for any reason, unless the amounts are covered under BYP Kids’ contractual agreement with insurance.

BYP Kids must, under federal law, accurately report the services provided to your children. Your insurance company may not pay for all services received. BYP Kids cannot change the service or diagnosis codes (unless they were initially reported incorrectly) in order to make a service “fit” your insurance plan benefits. We must report the exact services provided and the exact reason for providing them.

Your signature on this policy authorizes BYP Kids to release health information to insurance carriers when necessary for payment, and directs them to remit payment directly to BYP Kids (assignment of benefits). 

STATEMENTS 

Statements (bills) will be sent on a monthly basis when our system shows a patient (private) balance owing. The statement will list all activity on the claim(s) in question (insurance payments, insurance adjustments, patient payments, etc.) and will show the remaining amount owing, per date of service.

If you have a question or concern, or if you see a discrepancy on your statement, it is your responsibility to contact the Billing Office as soon as possible. If we do not hear from you we will assume the information in our system is correct and proceed accordingly. 

INTEREST 

Interest in the amount of 1.5% of your balance per month (18% APR) will accrue on accounts with private balances older than 30 days. 

PAYMENT PLAN OPTIONS 

When appropriate and at BYP Kids’ discretion, BYP Kids will offer monthly payment plans to help you manage your health care costs.

Payment plan duration will be no greater than 5 months unless special arrangements are made, again at BYP Kids’ discretion.

Interest will accrue on payment plan accounts, as listed above.

Payments are due on or before the agreed upon date. If payments are late or missed your account may be turned over to an outside collection agency without further notice.

Payment plans are intended to help bring past-due amounts current. All co-pays and deductibles are required at the time of service and will not be added to a payment plan.

Failure to follow any or all of the payment plan requirements will render the agreement null and void. 

CREDITS 

Any insurance credits or over-adjustments will be returned to the appropriate insurance company.

Any patient credits or overpayments will first be used to pay past-due balances, including those which may have been referred to an outside collection agency.

If patient balances have been resolved, patient credits will be returned to you (or the person/organization who paid). Please allow 2-3 weeks for processing. Smaller credits (generally under $20.00) may be left on the account to be used for future co-pays and/or deductibles. 

COLLECTIONS 

Your account may go to collections for the following reasons that include but are not limited to:

Invalid patient demographic information (address, phone, etc.) which prevents us from contacting you regarding your account.

Failure to provide timely, accurate insurance information.

Failure to pay patient balances.

Failure to follow through with payment plan agreements.

Failure to follow through with statement discrepancies, insurance denials or any other items on your account.

Failure to follow through with other correspondence from BYP Kids.

BYP Kidsmakes every effort to work with you to keep your account out of collections. However, in the event that your account is referred to a collection agency, you will be responsible for the balance of the account in addition to a 30% collection fee. You will also be responsible for any interest, service fees and/or legal fees that accrue while your account is in collections. 

RETURNED CHECKS 

Checks returned unpaid by your bank, regardless of the reason, will be posted back to your account in the original amount of the check, in addition to a $15.00 return check fee. You may also be responsible for interest, costs of collection, court costs and reasonable attorney fees as allowed by law.

Writing a bad check is a Class One Misdemeanor. BYP Kids reserves the right to prosecute to the fullest extent of the law when a check is returned unpaid from the bank. 

BANKRUPTCY 

If BYP Kids receives notice of a filed Bankruptcy case on your account, we will make the necessary adjustments according to bankruptcy law.

Your account will be placed in “bankruptcy” status, and you will be required to pay in full at the time of service, regardless of insurance coverage. We will be happy to submit a claim to your insurance on your behalf and, if your insurance pays on the claim, you will be refunded any overpayments.

Your account will remain in a “bankruptcy” status for two (2) years from the bankruptcy file date. If there has been no collection activity (multiple statements, letters, etc.) during that time, the bankruptcy status will be removed from your account and normal payment policies will apply. 

DISMISSAL FROM PRACTICE 

If you have any questions regarding your account, or need clarification on any of the items listed in this financial policy, please contact our Billing Department.

BYP Kids Billing Department Staff are available Monday thru Friday 8AM to 4:30PM.You can contact them by phone at (219) 662-3931.

Thank you for trusting Brickyard Pediatrics with the care of your children. We are dedicated to making your experience a positive one. Please do not hesitate to contact us with any questions regarding your account, payment options or financial responsibilities.

QUESTIONS OR CONCERNS 

If you have any questions regarding your account, or need clarification on any of the items listed in this financial policy, please contact our Billing Department.

BYP KidsBilling Department Staff are available Monday thru Friday 8AM to 4:30PM.You can contact them by phone at (219) 662-3931.

Thank you for trusting BYP Kids with the care of your children. We are dedicated to making your experience a positive one. Please do not hesitate to contact us with any questions regarding your account, payment options or financial responsibilities

Contact Us

Our Location

Find us on the map

Hours of Operation

Our Regular Schedule

BYP Kids

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-3:00 pm

Saturday:

Closed

Sunday:

Closed