Frequently Asked Questions

Candlewood Valley Pediatrics participates with many insurance plans. There are numerous HMO and PPO plans and the provider networks associated with those plans change frequently. The best way to confirm our participation with your insurance is by directly contacting the customer service department of your insurance carrier.

Please contact our billing department to be sure that we have the correct insurance information and that the correct insurance is billed. Do not wait, as insurance companies have strict time periods during which claims may be submitted to them.

Payments are generally collected at the time of service. Your bill may be for another date of service in which a copay was not collected. Please contact our billing department to confirm your outstanding balance and that it is not the result of an error. Use your receipt or cancelled check as proof of payment.

The payment of copays at the time of service is required by the terms of the contract between you and your insurance carrier. Many plans do not require the payment of copays for well visits and/or nurse visits. It is your responsibility to be aware of and understand the terms of your insurance plan. If you are not sure whether a copay is required for well visits and/or nurse visits, then it is easier for Candlewood Valley Pediatrics to bill you for the required copay after your insurance informs us that one is due, rather than have to reimburse you for an overpaid copay.

Candlewood Valley Pediatrics will file claims on your behalf with your insurance carrier if and when the proper insurance information is received. Health insurance contracts are agreements between the insured and the insurance company. Accordingly, it is your responsibility to be aware of and understand the terms of your insurance. Whether you have insurance coverage or not, you, as the responsible party, are ultimately responsible to make sure your bill is paid.

Many insurance plans include copayments, coinsurance and/or deductibles that are the patient’s responsibility to pay. Once your insurance has processed a claim, you will be billed for any coinsurance/deductible amounts according to the Explanation of Benefits received from your insurance company. If you have questions regarding how your insurance company processed a claim, please contact your insurance carrier directly.  If you have any additional questions, please contact our billing department.

The Candlewood Valley Pediatrics physicians recommend routine well visits based on policy statements set forth by the American Academy of Pediatrics (AAP). Some parents like their child to have annual physicals, or at intervals that differ from the AAP recommendations.  Some insurance plans have full well coverage; some provide for only those well visits that correspond to the AAP guidelines; others have no well coverage. It is your responsibility to be aware of and understand the limitations of your insurance. If you have questions regarding how your insurance company processed a claim, please contact your insurance carrier directly.

Generally, this means that your insurance will not pay the claim until it receives information from the insured as to whether the patient has other insurance. According to your insurance, you are ultimately responsible for the full amount of the claim until they receive the requested information. Please contact your insurance carrier directly to find out why the claim has not been processed and to find out what has to be done to get the claim paid.

Candlewood Valley Pediatrics accepts cash, checks, money orders, American Express, Visa and MasterCard. Please contact our billing department to make a payment by phone.

We encourage patients to use our Patient Portal for bill payments.

Payments may also be sent to:

Candlewood Valley Pediatrics
120 Park Lane, Suite A-101
New Milford, CT  06776

Please remember to include your account number with all payments.

Bills only reflect charges for dates of service for which there is an amount outstanding. Once a payment has been received for a charge that results in payment-in-full of that charge, that charge (and all associated payments) will no longer be printed on future bills. Please contact our billing department to confirm your outstanding balance and that it is not the result of an error.

Yes. Generally, payment of your bill is due within 30 days from when you first receive a bill. However, Candlewood Valley Pediatrics understands that special circumstances may prevent you from making full and timely payments. Please contact our billing department who will work with you to arrange an acceptable payment plan.

There are several possible reasons for this. Your payment may not have been received/posted before the bill was printed. Alternatively, we may have recently received information from your insurance company about an outstanding claim that was not reflected in your prior balance. Please contact our billing department to confirm your outstanding balance and that it is not the result of an error.

Payments are due 30 days after a bill is sent to you. Candlewood Valley Pediatrics understands that this may not always be possible, so additional bills may be sent to you. After a “final notice” is sent, your account balance is written-off and set up to be sent to collections. During this time, your balance in our system will be $0.00. Our computer system does not make it easy for our staff to remind patients of amounts that are already set up to be sent to collections.

In some cases, changes to a patient’s account may take a small amount of time. If you notice that a requested change does not appear to be reflected, please contact our billing department immediately. Do not wait, as insurance companies have strict time periods during which claims may be submitted to them. Make sure you obtain the name of the representative who is assisting you every time you call us so that we can monitor our service.

Some insurance plans may take up to 90 days to pay claims. In addition, there are many other reasons why insurance payments may be delayed, including issues that our billing department may be working on with your insurance. During this time, we do not send you any bills since we do not know whether or how much you may owe. Upon receipt of the Explanation of Benefits from your insurance carrier, you will receive a bill from us for any balance due. Payment of your bill is due within 30 days from when you first receive a bill, regardless of the date of service.