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We know it takes a lot to stay on top of everything.

Parenting life can be demanding! When you have one of those treasured free moments, we humbly ask that you read the tips to ensure you have the best patient billing experience.

Online Payments

Portal Changes: Our credit card portal was updated in August 2023 and has a new look and feel.

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Medical Billing: Winning the Insurance Game

Health insurance & medical billing is often complicated, confusing, and frustrating for our families. We want to partner with you to make it easier to understand and create a better experience overall.

There are a few critical things we need to be successful.  It is better for everyone if your insurance pays for your care quickly and without errors. 

  1. Help us help you: We have to know immediately if anything changes with your child’s insurance:
    1. Why?
      1. Insurance companies have hard deadlines that must be met in order for them to cover your care. 
      2. We submit claims to your insurance quickly- if all the info is right the first time we have the best chance of getting your insurance to pay for your care quickly, without hassle to you (bills direct to you, etc)
      3. It actually does matter if we have to resubmit/change your insurance: if we don’t get them your correct information the first time, it often takes many attempts to get them to pay for your care. This can be confusing because by the time we are able to bill you for your portion it can be many months later….AND if when that bill arrives you have questions or suspect errors we are already behind the curve. Sometimes, the clock has run out and we cannot rebill your insurance. (pesky insurance deadlines)  
  1. Statements communicate what your insurance decided: 
    1. The statements we send communicate their decisions on how much of the visit they will pay vs. what they expect you to pay. We are actually required by your insurance company to collect your portion (in order to be an in-network provider, among many other rules) and cannot change those amounts for you. (We would love to waive a magic wand but have to settle for being ethical.)
    2. Questions like “Why isn’t this covered” or “My deductible is met I shouldn’t owe anything” are actually best answered by your insurance company, who created the rules of your plan. Different insurance companies have different rules- even the same insurance company will process claims differently depending on the specific plan you are enrolled under. 
      • To be clear, we are always happy to review your bill with you and talk through what your insurance company has told us. We are more limited than they are in terms of answering all the “why” questions of your insurance coverage & don’t have access to all their information. We have a limited view. 
      • While we can’t change their decisions if no error has been made, we can help if there has been an error or a coding problem. We can act as your advocates when your insurance doesn’t pay something you feel they should. Contact us and we can review it!

How to get help:

Start by either emailing us at businessoffice@metropeds.com OR call our billing company at (855) 914-4603. 

If your concerns are still unaddressed, please call the clinic directly and report this to us- a manager will be assigned to intervene on your behalf. 

Common Issues:

  1. Received a bill for the whole visit? 
    1. Insured? It means there is an issue with the insurance information we have on file. Please email us a copy of the front and back of your insurance card to businessoffice@metropeds.com. Please include the name of the guarantor on the insurance/main policy holder on the insurance, as well as a list of all children the insurance covers. If each child has a different ID number, please send a copy of all cards. In your email, reference that this insurance is to update previously filed claims. 
    2. Uninsured? Please email businessoffice@metropeds.com and ask what can be done about your bill; we do offer a 25% time of service discount for uninsured patients as well as MN VFC vaccine rates (if you qualify).
  1. I am being asked to do a “Coordination of Benefits/COB, what is that?”
    1. If anyone in your family is covered by two insurance plans, OR if anyone gets in a car accident (even a year ago) and has medical treatment, your insurance company will often require you to contact them directly to complete a “Coordination of Benefits” or they will completely stop paying for all of your medical care.

      Why? This process helps ensure the insurance company knows “who is on first”. Basically, they want to make sure it isn’t someone else/another insurance company’s job to pay for your care. No one likes to pay bills they don’t owe, not even insurance companies. 

      Unfortunately this isn’t something anyone can do on your behalf and it is important to do so quickly- see information on insurance deadlines discussed above…it can mean you get stuck with the bill if it isn’t completed in a timely manner. 

      The good news is it is usually fairly easy to do- call the number on the back of your insurance card & tell them you need to complete a coordination of benefits.

Managing the cost of your family medical care:

The most important thing is to stay in touch with us. We know it isn’t fun to have to ask for a payment plan but we encourage you to do so rather than letting the bill age into collections. We want to do everything in our power to find a good solution and continue to provide care for your wonderful family.

Typically, all bills are due on receipt. If you are unable to pay the balance in full, please contact us at businessoffice@metropeds.com so we can set up a payment plan for you. Include several days/times we can reach you and which phone number to call.

We will automatically bill your card on a specified date each month. 

*Important* Keep opening your statements to make sure all is well. If your balance due increases because your family is seen again, please remember to call us to update your payment plan to include the new balance due. 

Self Pay Patients

We offer a 25% discount for self-pay patients (uninsured/not insured by a commercial insurance policy) paying at the time of service. You may also qualify for the MN Vaccines For Children program that reduces the costs of common vaccines to $10- please tell our front desk that you wish to self-pay and they can assist you. If you receive a statement and have concerns or feel you didn’t receive the appropriate discount please email or call us at businessoffice@metropeds.com/855-914-4603.

Unfortunately, we cannot offer this to patients who are insured due to insurance contracts. If your insurance applies the cost of your care to a deductible or patient responsibility portion we cannot write this off/switch to a self-pay discount as they consider it insurance fraud.

Price List

All Minnesota primary care providers are required to post a list of their top 25 most common preventative care services and procedures costing more than $25, along with the corresponding prices for each of those services. This list includes four amounts for each procedure: the providers’ charge, the average commercial reimbursement rate, the Medicare allowable payment rate and the Medicaid allowable payment rate.

View our clinic’s list of top 25 primary care services over $25