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Dear Parents and Guardians,

We wanted to take a moment to inform you that as of January 1, 2021, some changes have been made to the national guidelines for billing of medical office visits. One change in particular that we wish to describe to you is how billing for routine checkups works under the new guidelines. Under the new system, if we manage a medical problem during a checkup, we are required to document and charge for this service in addition to the usual charge for the checkup itself. For example, if your child has asthma and we discuss how your child’s asthma is doing and review the use of his or her asthma medications during a checkup, there will be a billing charge for the diagnosis and management of the asthma in addition to the usual charge for the checkup. Or if your child has ADHD, depression, or anxiety and we discuss your child’s ADHD, depression, or anxiety and review their medication during the checkup there will be a charge for the diagnosis and medication management in addition to the usual charge for the checkup.

While routine checkups generally do not involve co-pays or deductibles, you may be charged a co-pay or deductible when billing for a separate medical problem occurs during a routine checkup. Whether you are charged a co-pay or deductible depends on the medical insurance plan you have and is determined by your insurance company, not by our office. Any questions regarding your policy and or deductibles should be directed to your Insurer or Human Resource department. You may also contact our billing department if you have questions about a bill you receive from our office.

Sincerely,

Pediatric Associates of Hampden County, Inc.

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