Value Added Service Fee Program

Pediatric Associates of Austin, P.A.

Value-Added Program

“As a new patient to the practice, we want you to be certain that you will be 100% satisfied with the benefit of our value-added services. If you decide within your first year to transfer your records to another practicing physician, we will cheerfully refund your money.”

At Pediatric Associates of Austin, we are committed to providing the best possible care to our patients and families.  We have been practicing in Austin for almost 50 years and we love watching our families grow and thrive.  We cherish our relationship with you and hope that you find expertise and consistent quality in the services we provide. 

With the new year beginning, we wanted to share some information that may be helpful to you in understanding why we charge an annual Value-Added Service fee.

It was a hard decision to begin this program. We were faced with the dilemma of declining revenue and the ability to continue the high quality of care that the doctors and patients of PAA demand.

Employing a top-notch staff and having adequate time with each patient are vital in maintaining the highest level of pediatric medical care. Stacking patient schedules and eliminating RNs and laboratory services can reduce cost. The impact this would have, however, is not conducive to providing the best patient care experience that PAA strives to maintain.

Reimbursement from insurance companies has declined since the late 1990’s. Without the ability to negotiate adequate reimbursement from the insurance companies, we began our Value-Added Service Fee Membership Program in 2005 after one of the largest payers in Austin cut our reimbursement by 28%.

Pediatric Associates of Austin has many contracts with insurance companies that allow us to be in-network providers for our patient families. What you may not know is that medical practices that are in-network providers with insurance plans are unable to raise their fees.  The reimbursement from the insurance companies to provide this care is dictated  by the insurance company. Small practices like ours have no negotiating power. Given that there are only a few insurance companies that have the greatest market share, we have no choice but to accept what is offered. In addition, as the healthcare industry continues to evolve, we are seeing many insurance plans with no out-of-network coverage and/or they belong to narrow networks which limit the number of providers you have to choose from. We want you to know that despite the difficult financial relationships we have with insurance companies, we are working hard to keep those relationships so our patient families can continue to see us “in network “.

Other private pediatric practices in Austin have faced increasing financial and administrative uncertainty as well. Many have decided to join large corporate hospital groups based outside of Austin. Pediatric Associates of Austin wants to remain a private, independent pediatric practice. We value our close relationships we have maintained with our patients over the years and we value the “family atmosphere” that allows us to keep that special relationship with our patients. We want to maintain our autonomy that allows us to continue to offer quality care and convenience to our wonderful patient families. 

This fee is not voluntary and for legal reasons we cannot structure payment around services that you use or do not use or by the number of visits you have each year.  We understand that paying this fee is a very personal decision for your family to make. We understand if this is something that is not best for your family.  If you decide to leave the practice to seek care elsewhere and decide later you would like to return we will gladly welcome you back.  If you have a financial hardship, please let us know so we can work with you so you may remain in the practice.

Thank you for entrusting your child’s health care to us.  We look forward to taking care of your children for years to come.

Click to read more healthcare news:

Private Practice Departures

Blue Cross Blue Shield and Ascension

If you have any questions or concerns, please email patientcare@pediatricassociates.net 

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