Payment & Financial Policies

All of us at Green Tree Pediatrics believe it is essential to our patients and their parents that we outline our expectations regarding the financial aspects of your visits with us. We have developed these policies based on industry standards and past experiences. These policies are presented in order for you to understand how we interact with you, your insurance company, and some of the constraints we must follow due to contractual and/or legal requirements.

We hope you find these policies useful. As always, it is our philosophy to work with our patients and their families. Therefore, we encourage you to contact our Office Manager, (734) 769-3702, in the event you have any questions regarding the items listed below or if you feel you require any special considerations.

Billing Your Insurance

  • It is very important that we receive the correct insurance information and that you remember to update the office on any demographic changes.
  • We will bill your insurance for you. We must emphasize that as your child’s healthcare provider, our relationship is with YOU, not your insurance company. All charges are your responsibility from the date of service rendered.
  • All co-pays are due on the date service is rendered.
  • We accept cash, check, MasterCard, Visa and Discover.
  • If we are not contracted with your insurance, full payment is due at the time of service.
  • If you are self pay, full payment is expected on date of service rendered. You will receive a 20% discount if paid in full on date of service.
  • We will be happy to work with anyone on an unpaid balance. Please remember that if you have a patient due balance, payment MUST be received every 30 days to prevent the account from being sent to collections.

Billing for Services

  • This office can only code and file a claim for patients with a diagnosis that was encountered and documented in the medical record.
  • To request a diagnosis change solely for the purpose of securing reimbursement from an insurance carrier is inappropriate and is considered a fraudulent act.
  • All balances billed are due within 30 days of the statement date.
  • We have additional charges for missed appointments, emergency visits, visits during weekends and holidays and visits outside the hours of 8 am-5 pm (Monday-Friday).
  • Payment arrangements can be made if necessary with our billing department.

VFC Program

Green Tree Pediatrics participates in the Vaccine For Children (VFC) program through the State Health Department.  This program is designed to make vaccines available for uninsured and underinsured children. Through this program, we are able to administer vaccines at our office to children who do not have immunization coverage for a nominal administrative fee.


Overpayments or credits on a patient account will be refunded to whoever made the payment. Since we have family accounts, if there is a credit on one child’s account and a balance on another, this credit will be moved to the sibling.

Missed Appointments

Broken appointments represent a cost to us and to other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to bill you a missed appointment fee of $50.

Alternate Immunization Schedules

We recognize that some parents choose not to follow the American Academy of Pediatrics-recommended schedule for infant and childhood immunizations. We will continue to support parents’ decision-making authority to make healthcare decisions for their own children; however, we are unable to continue to bear the cost of administering personalized immunization schedules.

Effective May 11, 2009, when patients come to the office for administration of a vaccine(s) separate from their regularly scheduled appointment, this visit will include a charge for a nurse visit. We recommend that you check with your insurance company in advance as the nurse visit may NOT be a covered benefit. This policy does not apply to provider-initiated delays to the immunization schedule.

Please be advised that we cannot adjust this charge or related diagnosis for the sole purpose of securing reimbursement for your insurance carrier.

Telephone Calls

When telephone calls replace office visits, a telephone charge will be applied. Following the AMA guidelines for billing telephones calls. Telephone calls may not be a covered benefit. Balances that are not covered by your insurance company are your responsibility.

Returned Check Fee

There is a $25 fee for all returned checks. This fee must be paid prior to your next scheduled appointment.