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Billing and Health Insurance Questions
Health care insurance is intended to cover some, but not all, of the
cost of your child's medical treatment. Please familiarize yourself with
your specific policy by contacting your benefits office or by calling
the phone number listed on your insurance identification card. You
should be aware of any deductibles, coinsurance and copayments, as well
as, non-covered services.
You will be asked at each visit if your insurance is still the same. We
ask this question to keep our records as accurate as possible, and also
to properly file to your insurance company for payment of the services
we provide to your child. All patients receive the same medical
treatment in our office regardless of insurance coverage. However, there
are some administrative procedures that must be altered for certain
managed care plans.
Participating health plans change contracts frequently. Please check
with our business office if you are changing health plans. As of
9/1/08, we participate with the following listed insurance plans.
However, since contracts frequently change, it is important to call and
verify that we still participate.
FPA participates with:
Aetna
Alliance/One
Net PPO/Mamsi Life & Health
BCBS PPO
Cigna
Coventry/Southern Health
First Health
Great West
Humana PPO
Unicare/NCPPO
One Health
United PPO
FPA does NOT participates with:
Anthem Healthkeepers
BCBS Care First: Open Access OR Blue Choice
Beech Street
Care First/NCAS
Healthlink/NCPPO
Mamsova/MDIPA/ Optimum Choice
Medicaid
Multiplan/PHCS
Tricare
United HMO/EPO
We will file insurance claims for those patients with insurance plans in
which we participate. If we do not participate with your insurance
company and in the case of hospitalization, you will be provided with a
statement of the charges for services provided to your child in the
hospital by our physicians. This statement will satisfy the
"Physician/Supplier" section of the insurance claim form, which you are
responsible for filing to receive reimbursement from your insurance
company. The insurance company will usually respond to your request for
reimbursement within 30 to 45 days. If you do NOT hear from them within
this time, please contact them to determine the delay. You will continue
to receive a monthly statement from us until the account, which is your
responsibility, is paid in full.
Payment for all copays and non-covered services is expected at each
visit to our office. Payment may be made by cash, personal check, Visa
or MasterCard. |