What To Bring

  • Current insurance card

  • Your co-payment

  • Any past balances due

Insurance

We are contracted with the most major insurance carriers and will file with those plans as a courtesy to you. Eligibility is based on information you present and is confirmed prior to your visit. Our services are billed within 24 hours from time of the visit.

After 30 business days you are expected to pay any unpaid balances regardless of your insurance company's decision to deny coverage or to reimburse less than the allowable charge.

Patients who arrive to be seen in our office with invalid/terminated insurance, lack of proof of continuing coverage, or the wrong doctor's name on the card will only be seen if payment for the visit is received at the time of service. You may also elect to reschedule your visit.

Updated Information

Your current information is critical for billing and for our office to contact you if necessary. Your insurance plan requires you to keep our office current on any changes in address, phone number or coverage.

Parents should immediately contact their insurace plan to add their newborns to avoid paying out of pocket for services. Most insurances require this be done before your child is 30 days old.

Payments due at the time of service

If you have chosen an Insurance plan that requires you to pay a deductible amount, prior to being covered at 100%, we will collect payment for services at the time of service if your deductible has not been satisfied. Please contact your Insurance Carrier to have full knowledge of your benefit plan.

Payments are always required at the time of service. These include applicable co-insurance, co-payments, and any outstanding account balances. Failure to pay co-payments at the time of service is a violation of your insurance contract and may be reported.

Additionally, since most patients we see are under the age of 18 years, we consider the parent/guardian who arranged for the appointment and/or accompanied the child as the responsible party and will seek payment from that party. Often times, there are court orders that delineate financial obligations for medical care between a child's parents. Scottsdale Children's Group (SCG) is NOT a party to this court order or bound by this court order. These orders only establish responsibilities for the parents.

Personal & Business Checks

Scottsdale Chidlren's Group will no longer accept personal or business checks. We will be accepting Visa and Mastercard only. We apologize for any incovenience this may cause you.

Copy of Records

Fees for other records requests can be discussed with staff.

Missed Appointments

We request you cancel at least 24 hours prior to the appointment so that other patients can be scheduled in the time set aside for you. Failure to cancel will result in a $30 "no show" fee which is not a covered service and is patient responsibility. This fee also applies to appointments that are scheduled on the same day.

If the appointment is not canceled 4 or more hours prior to the scheduled appointment time the no show fee will apply. Should you fail to cancel two or more appointments, you may be discharged from the practice at the provider's discretion.

Collection Agency Policy

Failure to pay balances can result in the account going to an outside collection agency. Patients are usually transferred from the practice at this time as well. Please contact the billing department, and your account representative will work closely with you if you need to establish a payment plan. Any fees incurred from the collection agency may be assessed to your account.

Billing Department

Please call our billing department at 480-425-4890 to reach a billing representative.

Fee Schedules

Our prices are dictated by our insurance contracts and are competitive for the area. It is a violation of our contractual agreements with your insurance plans to discount or waive charges, changes diagnoses or procedure codes on charges for the purposes of coverage etc.

If you have any questions or concerns about any of this information, please feel free to contact our office.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an innetwork facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency services:
If you have an emergency medical condition and get emergency services from an out-ofnetwork provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center:
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:

  • You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
  • Generally, your health plan must:
    • Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in- network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact:

  • Call your health insurance company if you need help determining the part of the bill that they will be paying and for help in determining whether you are eligible for the dispute resolution (arbitration) process. Please visit https://difi.az.gov/soonbdr to view exclusions that apply under Arizona law.
  • Call the healthcare provider that sent the bill and discuss your concerns. In most cases, Arizona law requires providers to provide an itemized bill on request, so review the charges carefully. Some providers might accept a lower payment. You can compare the amount you were charged to the average market price using websites like NewChoicehealth.com, and FairHealthConsumer.org.
  • Submit a request for arbitration to the Arizona Department of Insurance: if you believe the bill, you received is eligible for arbitration. Visit https://difi.az.gov/soonbdr for more information.

Arizona Department of Insurance: 602-364-2399. The federal phone number for information and complaints is: 1-800-985-3059. Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.


AHCCCS Recipients - Please note that failure to disclose your AHCCCS eligibility will result in your financial responsibility for services rendered at this office.