Billing FAQs for Beaverton Families
Medical bills can be confusing, especially when a routine checkup turns into a conversation about a new concern. At Tanasbourne Pediatrics in Beaverton, OR , we want you to understand how pediatric billing works so there are no surprises. Below we explain why you may receive a bill after a well-child visit and what preventive care is included in your child’s checkup.
I Thought Well-Child Visits Were Covered at 100%. Why Am I Getting a Bill?
We do our best to address all of your child’s health needs at every visit, including regularly scheduled well-child checks. Most insurance plans cover the preventive care discussions and screenings that are part of the exam. However, when we address an illness or problem during the visit, such as an ear infection or a rash, or help manage a previously diagnosed condition like asthma or ADHD, that care is not considered preventive. Insurance companies may not include it in preventive coverage, and you may see an additional office visit charge for illness.
Tests, procedures, or discussions to diagnose or treat health problems are not considered preventive care, so you may receive a bill later. Examples of non-preventive care that may be provided during a well visit and carry an additional cost include:
- Discussing new symptoms
- Discussing an illness or existing condition
- Unplanned procedures
- Treatment or testing for new or existing conditions
- Medication management (for example, ADHD or asthma)
If your child needs care for a new illness, you can also schedule a separate sick visit.
What Care Is Included in a Well-Child Visit?
We follow the American Academy of Pediatrics Bright Futures Guidelines for pediatric preventive care. These recommendations include:
- A physical exam to check your child’s overall health and development
- Developmental screening to assess progress toward important milestones
- A vision screen to check for vision problems
- Immunizations to protect your child from preventable diseases
- Fluoride varnish to help prevent cavities
- A lead level test to check for lead exposure
- A hemoglobin test to check for anemia
- A lipid panel screen to check for high cholesterol or other heart disease risk factors
- An STD/HIV screen for adolescent patients
These services are not provided at every visit. They follow a standard visit schedule based on your child’s age.
Some health plans do not cover every recommended screening, even though they are the national standard of care. Please call your insurance company to check your benefits, and review the plans we accept on our insurance page. For questions about a specific bill, call our office at (503) 690-8195.
More Pediatric Billing Questions
Why was I charged a copay at my child’s well visit?
If an illness or existing condition was addressed during the well visit, your insurance may process that portion as a problem-focused visit, which can carry a copay or deductible.
Are sports physicals billed the same as well-child checks?
Coverage for sports physicals varies by plan. Some insurers cover them as preventive care while others do not, so check with your insurance company.
Is ADHD medication management part of a well-child visit?
No. Medication management for conditions like ADHD or asthma is not considered preventive care and may be billed separately.
Why does my insurance not cover every screening?
Some health plans do not cover all screenings recommended by the American Academy of Pediatrics, even though they are the national standard of care.
How can I avoid unexpected bills?
Call your insurance company before your visit to review your preventive and sick visit benefits, and let us know if you would like a new concern addressed at a separate appointment.
Can I pay my pediatric bill online?
Yes. Use the Pay My Bill link in our website menu to pay your balance online.
Who do I call with billing questions?
Call our office at (503) 690-8195 and our team will be glad to help you understand your bill.