Billing and Insurance
It is the policy of PPSW to provide essential services regardless of the patient’s inability to pay. Discounts are offered based on family size and annual income.
PPSW is currently contracted with most commercial insurance companies and Colorado public insurance, including: AHR, Anthem, Blue Cross/Blue Shield, CHP Plus (adminstered by Rocky Mountain Health Plans), Colorado Medicaid, Cigna, EBMS, Friday Health, HMN, IMS. Rocky Mountain Health Plans, RCI/Ska Brewing, San Juan IPA, Tricare West, and United.
We are NOT contracted with: New Mexico Medicaid, including all Salud and Centennial plans, Humana, Aetna, Cofinity, or Presbyterian Health Plans. We are contracted with some Meritain plans (depending on your employer), please call our office for more information.
If your insurance company is not shown listed above, please call your insurance company to determine if Pediatric Partners of the Southwest (Tax ID 20-2456419) is contracted and in-network.
Office Billing Policy
Pediatric Partners of the Southwest is committed to assisting our patients throughout the medical claims process. We ask for your cooperation in providing this service to you. It is important that you notify us immediately of any change of insurance, home address, telephone number or other important demographic information. Changes in your contact information such as address or phone may also be made via the patient portal.
The patient authorizes payment directly to PPSW for medical benefits. Patients are financially responsible to PPSW for services not paid by insurance or other third party payers. We offer a credit card on-hold option for our families.
Patient authorizes release of all information with respect to themselves or their dependants which may have a bearing on the benefits payable under this or any other plan providing benefits or services. If this account is sent for collection proceedings, additional court and interest fees may apply. An additional fee of $25.00 will be assessed to the patient’s account for a check returned for insufficient funds.
Saturday clinic is open to help our patients keep costs down by not having to utilize expensive hospital emergency or urgent care services. An additional fee of $45.00 is assessed to patients for Saturday visits and may or may not be covered partially or fully by insurance. Patient is responsible for any balance which is not paid by insurance.
Please refer to our direct line for billing questions: 970-403-1500
PPSW serves all patients regardless of ability to pay. There is a discounted fee schedule
available to families who are uninsured or otherwise in need.
We accept all Colorado Medicaid and Children's Health Plan (CHP).
Pay Bills Online
You can post payments directly to your account using this online link to Instamed.
Self-Pay and Public Insurance Options
Do you need assistance in acquiring health insurance for your child?
Your child may qualify for Colorado medical insurance programs at a reduced or free cost to you due to changes in healthcare reform. While historically you may not have met the financial guidelines, changes effective May 2010 via the Affordable Care Act make it easier to qualify. Both Child Health Plus (CHP+) and Medicaid provide quality health and dental care coverage.
For more information please contact:
San Juan Basin Public Health: Vivian Shawcroft, Family Health Coordinator, 970-335-2022. Vivian can refer families to the appropriate agency for Medicaid, CHP+, and CARES sliding scale program.
The La Plata Family Centers Coalition: Family Health Advocate at firstname.lastname@example.org or 970-385-4747 (Se habla español)
PEAK program: An online program that allows Colorado families to check if they may be eligible for health benefits, and also check the status of their public assistance benefits. http://coloradopeak.force.com/
Health Insurance Exchange: Connect for Health Colorado is the health insurance marketplace, established under the Affordable Care Act. The insurance exchange enables patients to shop, compare, choose and purchase the health plan that is right for your family. Visit http://www.connectforhealthco.com/