Patients must understand their responsibilities under their insurance plans to avoid unexpected charges.

• Insurance Policy Understanding: Patients should know that an insurance policy is a contract between the insurance carrier and the subscriber, not the physician’s office.

• Keeping Insurance Information Updated: Patients are responsible for keeping their insurance information current with the physician’s office to avoid claim submission delays that could result in charges becoming their responsibility.

• Payment and Pre-authorization: Providing insurance information does not guarantee payment; patients must contact their insurance to determine if a procedure needs a pre-authorization and verify if the Dundee Pediatrics/Dr. Daill is an in-network provider.

• Newborns and PCP Listings: Patients must add newborns to their plan within 30 days and ensure their primary care physician (PCP) is Dr. Michelle Daill to avoid denied claims.

• Accepted Insurances:  You can find a list of insurance carriers Dundee Pediatrics and/or Michelle Daill, MD accepts here.  Please be aware that the insurance accepted at our office doesn’t guarantee we are in network.

• Coverage:  Patients are responsible for knowing what their benefit plan out of pocket is.  Subscriber/Patient out of pocket can include, but not limited to, Co-pays, Co-Insurance, Deductibles, and non-covered services.

• Claims:  If your claim(s) have been denied, you should first contact your insurance’s member services to determine why the claim(s) was denied.  It is then your responsibility to contact our office within 30 Days to have the claim resubmitted to your insurance to avoid time limit denials which will result in the balance becoming the patient’s responsibility.  Providers are required to submit claims within 90 days of the date of service and resubmissions must be submitted within 60 days of denial.  Some Common denials include:
  • Coordination of Benefits needs to be updated
  • Your newborn has not been added to your policy
  • Service is not covered under your policy benefits
  • Your coverage is in-active   

• Recommendations:  We recommend maintaining a member account on your insurer’s website and logging in before each appointment to ensure your policy is still active, verify that Dr. Dall is your PCP, to verify in/out of network status, and know your benefits and patient responsibility.