Finanacial Policy

Thank you for choosing Mountain Area Pediatric Associates! Our physicians and staff are committed to providing you and your family with quality care. Please review our financial policy as it pertains to insurance and payments, and do not hesitate to contact our office with any questions you may have.

Insurance Participation

  • • Aetna
  • • BCBS
  • • Cigna
  • • Crescent
  • • Medcost
  • • Medicaid/NCHC
  • • United Healthcare
  • • UMR
  • • Tricare
  • • Medcost

Click each section for details:

Medishare and Other Cost-Sharing Services

  • If you participate in MediShare or another cost-sharing service we do not file these claims for you, as they are not insurance companies.
  • You will be considered as SELF-PAY at the time of service.
  • Upon your request, we can provide you with a detailed summary of services rendered.

Self Pay Policy

  • Mountain Area Pediatrics offers a 15% discount to our selfpay patients if payment is made in full on the date of service.  This occurs when you check out at the end of the appointment.

Proof of Insurance

  • Please be sure to bring your child’s insurance ID card with you to each visit.  If you have received a new card in the mail since your last visit, please let our front office staff know.
  • If you do not have current insurance information with you and we are not able to verify eligibility for your child, you will be asked to pay for services at the time they are rendered.
  • It is your responsibility to provide our office with any changes in insurance.  Insurance companies have a window of time in which we are allowed to file claims.  If we do not receive correct insurance information for your child within this time frame, your insurance company will deny the claim and the balance will be your responsibility.
  • SECONDARY INSURANCE:  Please make sure that we know if your child has a secondary insurance policy.

Co-Payments

  • If your insurance policy specifies that you have a co-payment for office visits, we will collect this amount during the check-in process.  This must be paid on the date of service.

Newborns

  • Please be sure to add your newborn to your insurance policy within at least 30 days of birth.
  • Contact the Mountain Area Pediatrics Insurance & Billing Department as soon as your newborn is active on the policy.  Until this takes place, you may receive a bill for any visits that have occurred since the date of birth.  Once Mountain Area Pediatrics receives the active policy information, we will bill these claims to your insurance company.
  • Please provide Mountain Area Pediatrics with the following information:
    • Insurance company
    • Subscriber name & date of birth
    • Member ID number
    • Group ID number (if applicable)
  • Bring your insurance card with you to each visit

Circumcisions

  • Please check with your insurance company to confirm coverage of circumcisions. If this is a covered procedure, we will bill your insurance company.
  • Circumcisions are not covered by Medicaid.  Therefore, for all MEDICAID patients, we require payment IN ADVANCE of the scheduling of the circumcision.
    • If paying with CASH, the cost of the circumcision is $276
    • If paying with CHECK or CREDIT CARD, the cost is $325
  • Cash & check payments can be made in person with the front office staff.  Credit card payments can be made over the phone or in person.

Co-Insurance & Deductibles

  • Once your insurance company has processed the claim, we will then send you a statement for your responsibility.

Payments

  • We accept CASH, CHECKS, and VISA/MC/AMEX/DISCOVER credit cards.
  • Payments may be made with the front office, via mail, by calling our Billing Office or via our website. You may receive an email from our billing team outlining your remaining balance with a link to make payments, as well.
  • Payment plans are available and arrangements may be made by contacting our Billing Office.

After Hours Fee

  • When utilizing our EARLY MORNING walk-in clinic, our AFTER HOURS evening clinic, or for visits on the WEEKENDS & HOLIDAYS, we charge a $30 fee.  **This fee may or may not be covered by your insurance company.**
  • Billing Office Main line:

    (828) 254-5616

  • BCBS & Medcost policies:

    Susanna Kirksey, CPC (828) 350-3435

  • Medicaid/NCHC and Self Pay Accounts:

    Dawn McManus (828) 350-3346

  • All other commercial insurance policies:

    Cathy Duncan (828) 350-3437

PRESCRIPTION REFILLS
Prescription refills may be requested via telephone or in the office. Prescription refills may be requested by 3:00pm daily (Monday – Friday) to be available by 10:00am the next weekday morning (in most cases). Please note: prescription refill requests for ADD/ADHD medication require at least 3 days advanced notice (due to the fact that the attending physician must provide the refill prescription). Prescription refill requests will not be addressed outside of regular business hours. You can also request prescription refills through the portal.

WELL CHILD EXAMS
Prescription refills may be requested via telephone or in the office. Prescription refills may be requested by 3:00pm daily (Monday – Friday) to be available by 10:00am the next weekday morning (in most cases). Please note: prescription refill requests for ADD/ADHD medication require at least 3 days advanced notice (due to the fact that the attending physician must provide the refill prescription). Prescription refill requests will not be addressed outside of regular business hours. You can also request prescription refills through the portal.

AFTER HOURS NURSING ASSISTANCE 
Mountain Area Pediatrics representatives are available 24 hours/day – everyday. We make every effort to be available to meet the medical needs of your child(ren). In an effort to assist you even when we are closed, please feel free to utilize our nursing telephone triage service. The contact information for the triage service is readily available by contacting our office at 828-254-4337 anytime the office is closed or by calling the nursing triage service at 828.299.7234. Please note that the after hours triage nurse will not be able to address concerns relative to scheduling, prescription refill requests, or business/account issues.

INCLEMENT WEATHER 
Mountain Area Pediatrics hours of operation may be modified in the event of inclement weather. In the event of inclement weather, we may either modify hours of operation or close for the duration of the treacherous weather event. Our primary concern is the safety of our patients, our patients’ representatives, and our MAPA team members. Our physicians and staff will make every effort to be available at the office; however, our efforts may be hindered due to weather/road conditions beyond our control. IF YOUR CHILD IS EXPERIENCING A MEDICAL EMERGENCY, PLEASE CALL 911 OR PROCEED TO THE NEAREST HOSPITAL EMERGENCY ROOM. For non-emergency assistance, you may also contact our telephone nurse triage service at: 828.229.7234 at times when we are closed.

APPOINTMENT AVAILABILITY 
We make every effort to accomodate your request(s) for appointments during specific time frames. Please be aware that all of our patients are pediatric patients. It is typically not possible to accomodate a request for appointment times outside of “school hours” – especially for routine visits.