Billing and Insurance Information

Billing:

Foster City Pediatrics has staff members dedicated to helping you with insurance and billing questions. Our office manager is Janette Vogel and our bookkeeper is Coleen Gosselin. In order to help you, we need your up-to-date insurance information. We also encourage you to read your insurance company's Explanation of Benefits (EOB), which you should receive after we bill them. The EOB will spell out exactly how much they are paying and how much (if anything) is due from you. Janette or Coleen can be reached at 650-341-7098 Monday through Friday during regular office hours. (Note: Patients covered by an HMO plan generally do not receive an Explanation of Benefits)

If your insurance requires a co-payment, it is due at the time of the visit. We accept cash, personal checks, Visa or MasterCard as payment. We do not bill for co-payments, so if your child comes alone or is accompanied by someone other than a parent, please make sure that your child's insurance card and co-payment accompany him/her.

If you do not have a valid insurance card at the time of your child's visit, you will be asked to sign a waiver for services incurred.

Insurance:

HMO (Managed Care)

Foster City Pediatrics participates in several HMO plans through Mills Peninsula Medical Group. It is important that you refer to your plan's benefits to fully understand how your insurance works. Here are some helpful hints:

The name of your child's primary care physician in our office should appear on his/her card. If the name of a physician who is not in our practice is on your card, your insurance will not pay for your visit in our office. If you wish your child to be seen in our office, you must call your insurance company and request the change prior to the appointment. If your HMO card does not have one of our physicians' names or our phone number, please call our office so that we can assist you in verifying your coverage.

In order to see a specialist, you must request pre-authorization from your child's primary care physician. Our office then requests the authorization from Mills Peninsula Medical Group. The authorization to see the specialist will be mailed to you by Mills Peninsula Medical Group. This generally takes 3-5 days unless it is urgent, in which case authorization can be obtained immediately.

If you have a newborn, in the case of HMOs, the baby is usually covered the first 30 days under the mother's insurance. If the mother's primary care physician is not part of Mills Peninsula Medical Group, you should call your insurance to see how they would handle your baby's first visit. Some insurance companies will allow you to add the baby to Mills Peninsula Medical Group during the first 30 days, while others will not. This may affect whether or not your insurance will pay for the first visits to our office.

List of HMO Plans in which FCPMG participates

PPO
We participate in several PPO insurance plans. In order to bill your insurance, we must have a valid insurance card. In addition, many plans do not cover all services. We will bill you for any services provided, but not paid for by your insurance company.

Please familiarize yourself with your plan's benefits. Many of the PPO plans have deductibles that you must pay before your insurance begins to pay. In addition, many plans do not cover all services and we will bill you for those when we have received a reply from your insurance company. Referring to the Explanation of Benefits that your insurance sends you (some are available on their websites) will help you understand what is and is not being covered.

If you have any questions regarding your bill, call our billing office at 650-341-7098 during regular business hours.

List of PPO Plans in which FCPMG participates

Medi-Cal
We accept a limited number of new Medi-Cal patients through the Health Plan of San Mateo. If you wish your child to be a patient in our office, call the Health Plan of San Mateo at 650-616-0050 and they will let you know if there are openings in our case management list. We also accept Healthy Kids and Healthy Families through the Health Plan of San Mateo. Again, if you wish your child to be seen by one of our physicians, you must call the Health Plan at the number above.



Privacy Policies

It is the policy of our practice that all physicians and staff preserve the integrity and the confidentiality of protected health information (PHI) pertaining to our patients. The purpose of this policy is to ensure that our practice and its physicians and staff have the necessary medical information to provide the highest quality medical care possible while protecting the confidentiality of the PHI of our patients to the highest degree possible. Patients should not be afraid to provide information to our practice and its physicians.

We make a record of the medical care we provide. We use this information and any records sent to us from others to provide care for your child, to refer him/her to a specialist, for billing and insurance purposes.

A copy of our practice's Privacy Policy, which is available at the link below, will be given to you on your first office visit.

If you have any questions, please contact Janette Vogel, our office manager, at 650-574-2774.

>> Notice of Privacy Practices


All forms are PDF files and require Adobe Reader.
Download Adobe Reader for free.