Forms
Payment
Payment is due at the time of service, and we accept cash, check and credit. If needed, we can arrange payment plan as well.
If your account has a remaining balance, a monthly statement will be sent to you until it's paid.
Insurance
If we participate with your insurer, we will submit directly to them.
If we don't participate with your insurer, payment is due at the time of service and we'll supply you with the forms to submit to your insurer.
Insurance companies accepted: Priority Health, BCBS, Blue Care Network, ASR Physician's Care, Aetna, Cigna, Champas Tri-Care, Humana (Choice Care), Cofinity, Great West, Messa, PHCS (Multiplan) and United Health Care.
Self Pay Patients - Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical expenses at Rockford Pediatrics will cost. Please call our office to request an estimate prior to your appointment.
To find out more about a “Good Faith Estimate,” go to www.cms.gov/nosurprises
Late Arrival Policy
To allow us to serve everyone and ensure we have enough time to give you our specialized, personal treatment, we ask you to arrive on-time for your appointment. If you're more than 15 mins late, you may be asked to reschedule your appointment.
Vaccine Policy
Families should be aware that we are a pro-vaccine office. We want families to know that we offer a safe environment for their children. To ensure this, we encourage families to follow the recommended vaccine schedule established by the American Academy of Pediatrics.