Update on Sprout Pediatrics billing

Medical billing is convoluted and confusing so if you have ANY questions about your bill, please send us a message in the portal and we will address it as quickly as possible.  

Your “patient responsibility” is determined by your insurance company and contract, and is not in our control. Our contracts with insurance companies require our charges to be uniform, and we are prohibited from making changes or adjustments other than those made on a case-by-case basis with parents who request reconsideration. 

We’ve recently changed to a new billing system and are catching up and fixing several errors made by our previous billing service. We appreciate your patience as we organize our accounts and learn to navigate the new system.

We do our best to catch and solve billing errors before sending out statements. On occasion, you may need to contact your insurance provider directly. If this is necessary, we will offer as much guidance as possible. 

Due to the change in systems and portal, some charges will show as “balance forward” with the date of service and a description. With all cases, the best place to find details regarding your visits, charges, and balances is on the Explanation of Benefits (EOB) that your insurance provider sends for every claim. 

The portal shows your total family balance. We are happy to email or upload a statement for anyone requesting one via email or the portal. We are working on uploading statements for any child whose balance is over $200. 

We understand that some accounts have accumulated large balances which may be difficult to pay in full right away. The portal accepts both full and partial payments. Please message us via the portal if you need to make partial payments, would like us to charge the card we have on file, or want to arrange an automatic payment plan.  

The charges on this statement represent the amount that your insurance plan(s) have determined to be your responsibility. The amounts vary depending on your particular plan which may require any or all of the following “patient responsibilities”: copayment (due at time of service, typically a fixed dollar amount), coinsurance (determined after the appointment by your plan, usually a percentage), deductible amounts (dependent on your plan and family claims, an amount you must pay before your insurance coverage kicks in), and non-covered services (services that are recommended and/or standard of care, but which your specific plan has excluded from coverage). Most preventative services should not be subject to deductible or copayment, but this is not universal.  

Thank you for sharing your children with us, and being part of our tiny, different clinic! Feel free to message us or give a call with any questions you might have!