Forms/Policies
New patient
Patient info
Medical history
Consent to treat
Policies
Notice of privacy practices
Financial policy
Parent Resources
Medical records request from Becker Pediatrics
Medical records request to Becker Pediatrics
DIVORCE CASES
In cases of divorce, the parent bringing the patient in for care is responsible for payment of co-pays, coinsurance and non-participating insurance balances at the time of service. Parent or legal guardian bringing a child in for treatment is responsible for all co-pays, deductibles and co-insurance at the time of service.
CHILD CUSTODY CASES
The parent with primary custody is usually the parent with whom the child lives and who usually brings the child to the practice for care. The custodial parent is responsible for payment at the time of service whether the account is considered self-pay, participating insurance or nonparticipating insurance. If the noncustodial parent carries the insurance on the child, the practice will bill that insurance company, The practlce does not get involved with divorce specifics, e.g., one parent pays 80% and the other pays 20%. It Is. the parents' obligation to work out an agreement themselves or through the court system.
OFFICE POLICY
Before your child's first appointment, please have all previous medical records sent to us. We participate with most insurance plans, and accept payment by check, cash, or credit card. Payment is due at the time of visit.