(513) 398-3900

6400 Thornberry Ct, Ste 610
Mason, Ohio 45040


Muddy Creek Pediatrics Payment Policies 

Thank you for being part of the Muddy Creek Pediatrics family.  We do everything we can to be clear about our payment policies and charges for services.  If you ever have any questions or concerns about our billing, please call and speak to our Billing Supervisor or Practice Manager as soon as possible so we can answer your questions.

There are many different types of insurance plans offered now. For a list of the insurance plans we accept, please click here.  Many insurance policies have high deductibles in order to have lower premiums, so we have made a few changes to account for these plans.

  1. Co-payments and deductibles:  You are required to make your co-pay at the time of service. This is an agreement between you as the policy holder and your Insurance Company.  If you have an HDHP (High Deductible Health Plan) with an HSA (Health Savings Account) we will file your claim to your insurance company.  Patients with balances due will receive a statement in the mail, and balances are expected to be paid promptly.  Our front office staff can also collect balances due on accounts if you are in the office for another appointment.  We accept cash, check, Visa, MasterCard, Discover, and American Express. There will be a $30 charge for returned checks.
  2. Monthly payment plans:  Should you need to be set up on a monthly payment plan, this option is available under special circumstances. Please contact our Billing Department to discuss it with us.
  3. Insurance: In order to avoid being responsible for payment in full, you will be required to present a current insurance card at each visit.  Additionally you will be required to update a registration form once per year, as we must have your signed authorization to bill your insurance company each year.
  4. Missed appointments: Please notify us as soon as possible if you need to cancel an appointment since someone else may want the time slot reserved for you. A charge will be billed to your account for missed appointments not cancelled 24 hours in advance. The charge will be based on the type of appointment and the amount of time allotted for the appointment, and could be as much as $50, and will be charged per patient scheduled.  We will attempt to notify you of an appointment within 48 hours of your scheduled visit but ultimately, it is your responsibility to call us to cancel if you cannot keep your scheduled time.  Should missed appointments become habitual, the physicians at Muddy Creek Pediatrics may choose to no longer care for your family.  In that case, the guarantor of the account will be notified by certified mail and will be given adequate time (30 days) to find a new medical provider.
  5. Divorce:  In the case of divorce or separation, the parent bringing the child for care will be held responsible for payment of the account.  If the divorce decree requires the other parent to pay part or all of the treatment cost, it will be the responsibility of the parent bringing the child for care to pay the account and then collect reimbursement from the other parent.
  6. After hours phone calls for prescriptions: For non-emergent issues of prescription refills, we ask that you please call during regular office hours; otherwise a charge of $20 may be billed to you.
  7. Forms and letters: We are happy to fill out school, camp, sports, day-care, medication, and other forms at the time of the well child visit. It saves us time to fill out these forms as the visit is being completed and the chart is open. Please give these forms to the medical assistant at the beginning of the visit.
    Forms can certainly cover a wide range from Sports Physical Forms to Work Permits.  We also sometimes are asked to complete adoption paperwork.  There will be a $5 – $25 charge for forms filled out at other times, based on the length of the form, and payable when the form is picked up.  There will be a $25 charge for the completion of FMLA papers.  We ask that you allow 24-48 hours for the completion of all forms that are presented at any time other than at the well child visit.
    We do not charge a fee for a copy of a child’s immunization records.
  8. Records: You may obtain a summary of your child’s care from our patient portal. If you need a more comprehension copy of your child’s records please contact the office to make arrangements to obtain them. A medical records release form is required before records can be released. Muddy Creek Pediatrics will use the current State of Ohio approved fees for copying records. There is no charge for records faxed to specialists to coordinate care.  All account balances must be paid before records are released.
  9. Past Due Accounts:  If your account becomes past due, we will take the necessary steps to collect the debt.  We will make every attempt to set up payment arrangements with families that are going through a financial hardship. If we have to refer your account to a collection agency, you may be charged additionally for any collection agency costs incurred.  If we have to refer collection of the account to an attorney, you may be charged additionally for any attorney fees we incur, including court costs.  Please note that if your account is referred to a collection agency or an attorney for collection, the physicians of Muddy Creek Pediatrics may no longer be able to provide care for your family.  In this case the guarantor of the account will be notified of this by certified mail and will be given adequate time (30 days) to find a new medical provider.
  10. Other Fees as Required:  Over the last several years medical practices such as ours have experienced a steady increase in the time our staff is required to spend on services that are not reimbursed by insurance. These services require a careful review of your chart and often require physician involvement. Because office charges and payments are largely determined by managed care organizations, we cannot build in adjustments to cover the time required to complete these services for you. Rather than requiring an office visit to complete these services, and causing inconvenience to our patients and parents, we have certain charges for these services. These fees will not be billed to your insurance company and will be your responsibility. Most of our other fees are for completing forms and FMLA paperwork.  Please see item #7 on this page for more information.  We do not charge a fee for a copy of a child’s immunization records.

We appreciate your compliance with these policies. We strive to provide excellent, cost effective medical care in an ever-changing health care environment. We are happy to discuss any questions you have about these policies.