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The Hirsch Pediatrics FAQ's and Policies...
Billing
and Insurance
Are
there additional fees including those for school/camp forms, after-hours
phone calls, prescription refills, or copies of my child’s
records?
No. There are no
additional fees for other standard services such as completing
school/camp forms, after-hours phone calls, prescription refills,
or copies of your child's records.
How
do you manage insurance and billing?
In-network care
We participate with the
following insurances listed below. We also participate with several
smaller insurance plans that are not listed below. Please
call our office if your insurance is not listed under the in-
or out-of-network section.
Adventist
Health
Aetna
Beech Street PPO
BlueCross BlueShield
CareFirst
Cigna
Coventry
Great West
Johns Hopkins Employee Health Plan
NCPPO
PHCS
Tricare Standard PPO
Unicare
Note: If your
insurance plan requires you to designate a primary care physician
("PCP"), you must select our office prior to your first
visit. If Dr. Hirsch is not designated as the PCP prior to the
first visit, you may incur extra costs if the insurance company
requires us to process the claim as an out-of-network visit.
Out-of-network
care
We also welcome families
who wish to be part of the Hirsch Pediatrics family and are self-pay
or will utilize their out-of-network benefits. Despite having
in-network benefits at other offices, many families prefer to
use their out-of-network benefits at Hirsch Pediatrics to enjoy
the patient centered, family like atmosphere of our unique solo
practice.
The following insurances
will utilize their out-of-network benefits for care at Hirsch
Pediatrics.
Alliance
MAMSI
OneNet PPO
Optimum Choice
United HealthCare
In using your out-of-network
benefits, we will collect the entire appointment charge from you
at the end of the appointment. We will submit to your insurance
carrier the necessary medical claim forms on your behalf, and
the insurance company will then reimburse you directly for the
visit.
The amount of reimbursement depends
on your out-of-network benefits. Hirsch Pediatrics will assist
you and provide any additional paperwork needed to ensure you
are appropriately reimbursed. Please note that in some instances
the appointment costs will be the same or only slightly greater
than the cost you would have incurred by paying your co-pay with
an in-network provider. This is especially true for plans that
have above average out-of-network benefits and for plans that
involve a Flexible Spending Account (FSA) or Health Savings Account
(HSA).
Also, once you join
the Hirsch Pediatrics family, you will never have to switch practices
because of an increasingly frequent change in your insurance carrier.
As long as you continue to receive out-of-network benefits, we
will always make sure you receive the appropriate reimbursement
for your visit. Thus you can truly have a medical home - a pediatrician
that will care for your child from birth until adulthood.
If you would like more
detailed information on the expected out-of-network costs for
your family, please call or e-mail our office.
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