Coding an Office Visit

Federal laws require Alpine Pediatrics to submit every claim to an insurance company accurately, reporting the exact services performed and the exact reason for performing them. Sometimes insurance companies may not pay all charges as they were submitted by Alpine Pediatrics.  We cannot change a diagnosis code or a procedure code after the original claim submission just so insurance will pay the claim or specific services. 

We may change the code if it was initially submitted incorrectly.  Sometimes during a preventive health visit, the physician will diagnose and treat another problem. Services for the other problem will be billed as an additional charge. Some insurance companies will not cover two office services on the same date so payment for one of the services may be denied by the insurance company or an additional co-payment may be required. 

After we receive a response from your insurance, you will receive a statement indicating any amount that you may owe. Payment is expected at the time of service.  We realize, due to benefit coverage, you may not know the exact amount to pay. We ask that you pay immediately upon receipt of your first statement any and all balances which are due.