Located at 2921 S Meridian Rd, Meridian, ID

Insurance

Understanding Your Insurance Benefits

Health insurance can be confusing, and we want to help you understand what to expect before your child's visit.

Every insurance plan is different. Even if we are in-network with your insurance, you may still have out-of-pocket costs depending on your specific plan. These out-of-pocket costs are determined by your insurance company—not by our office.

Common Insurance Terms

Premium: The monthly amount you pay to keep your insurance coverage active. If your health care coverage is through your employer, these premiums are usually deducted from your paycheck.
Deductible: The out-of-pocket amount you must pay for covered healthcare services before your insurance begins sharing the cost. Many families have high-deductible health plans, meaning they may be responsible for most or all of the cost of visits until the deductible is met.
Copay: A fixed dollar amount you pay for certain medical visits or services.
Coinsurance: After your deductible is met, you may still be responsible for a percentage of the cost of your child's care (for example, 20%), while your insurance pays the remaining percentage.
Out-of-Pocket Maximum: The most you will pay for covered medical services during your plan year. Once you reach this amount, your insurance typically pays 100% of covered services for the remainder of the year.

Our Evaluation Process

At Arrowleaf Developmental Pediatrics & Autism Care, we typically follow a two-visit comprehensive evaluation model to provide a thorough and individualized assessment of your child.

Visit 1: An initial developmental-behavioral consultation to review your child's medical, developmental, educational, and behavioral history, discuss your concerns, and determine the most appropriate evaluation plan.

Visit 2: A developmental testing visit, during which standardized developmental and/or autism-specific testing is completed, interpreted, and integrated with the information gathered during the initial visit to help establish diagnoses and recommendations.

Because the second visit includes a medical evaluation, standardized developmental testing, and discussion of results and recommendations, it is typically the most expensive appointment. Developmental testing is billed separately from the office visit, and many insurance plans apply these testing services toward your deductible rather than covering them with only a copay. As a result, families with high-deductible health plans or coinsurance may have higher out-of-pocket costs for the developmental testing visit.

Follow-up appointments after the comprehensive evaluation generally do not include developmental testing and are typically associated with lower out-of-pocket costs.

Understanding Your Coverage

As a courtesy, our office verifies your insurance eligibility and benefits before your appointment whenever possible and can provide a good-faith estimate of your expected financial responsibility based on the information available to us. However, benefit information provided by your insurance company is not a guarantee of payment. The final determination of coverage and your financial responsibility is made by your insurance company after your claim has been processed.

It is the family's responsibility to verify that our providers and services are covered under their specific insurance plan. We encourage you to contact your insurance company before your appointment if you have questions about your network status, referral requirements, prior authorization requirements, deductible, copay, or coinsurance.

While our office obtains prior authorizations when required and feasible, prior authorization is not a guarantee of payment. Your insurance company makes the final decision regarding coverage after reviewing the submitted claim.

If your insurance processes a claim as out-of-network, denies coverage, or determines that a service is not covered under your plan, you are responsible for any remaining balance.