Billing

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Pendleton Pediatrics Billing Policy

Pendleton Pediatrics is contracted with most insurance plans. If we have a contract with your plan, we will bill the insurance company for the services we provide in the office. If you do not have insurance, or have insurance but a service provided is not a covered benefit, all fees are to be paid at the time of visit.  We offer a discount for cash paying patients who pay in full at the time of service.  We will be happy to provide a fee schedule at your request.

Insurance Pre-Verification

We try to contact insurance companies prior to your appointment to facilitate the registration process. Please let us know if your insurance has changed at the time of making the appointment. This will make it possible for us to verify your insurance the previous day and will decrease your wait time. It is your responsibility to verify with your insurance company that Pendleton Pediatrics is contracted and to know your benefits.

At the time of your visit please bring the following items:

  • Patient’s insurance card
  • Co-Pay and/or balance due will be collected at time of service.
  • Medical records from other offices (if available)
  • Patient’s vaccine records (if available)
  • Parent and/or Legal Guardian must accompany the patient for visit

If you have an HMO insurance or are on AHCCCS, you must call your insurance company before your appointment date to make sure the patient is assigned to one of our providers or offices as their PCP (Primary Care Provider). If the patient is not assigned to us upon your appointment time, your appointment may be rescheduled.

Please bring your child’s insurance card with you to every visit. We will make a copy of the card. This copy is used to submit an insurance claim for the visit. It is very important that the insurance card be a current copy and that the card lists the name of the child, who is being seen for that visit. If you have recently enrolled in a new insurance plan, you may bring a copy of your enrollment form until you receive the new card.

For newborns, we are able to accept a copy of the parent’s insurance card up until the first month visit. After that time, we must have a copy of the child’s card which will be required at the time of check in. You are required to add your child to your insurance plan within 28 days. Failure to do so may result in nonpayment of claims made.

If you are unable to present a current insurance card for your child, you will be asked to sign an Insurance Coverage Waiver form.

Co-payments, co-insurance, deductibles

We collect all estimated patient co-payments, co-insurance or estimated deductibles at the time of check-in. If you are unable to pay at the time of your appointment, your appointment may need to be rescheduled. Insurance provides reimbursement on allowed medical charges.  As a courtesy to you, we will provide an itemized statement that you may send to your insurance company for payment.  We will be happy to submit to most insurance carriers, if you have provided us with policy numbers, address, place of employment and any other pertinent information.  You are responsible for all deductibles and charges not covered by insurance.

Additional Information

There will be a fee assessed for paperwork that requires a provider’s attention.

We are pleased to accept cash, check, MasterCard, Discover, VISA or AMEX or care credit for your convenience. If you need to arrange a payment plan, please contact our Billing Office.

A $25 charge will be added to your account for returned checks.

All scheduled appointments cancelled with less than 2 hours notice will be charged a $25 fee; no show charges are not covered by insurance plans.

If records are being released to anyone besides a physician there is a $25.00 fee per chart plus 10 cents per page.

If you have any questions regarding our billing policies or if you need to make financial arrangements with our office, please feel free to contact our billing department at (480) 385-5055.