Chapel Hill Pediatrics and Adolescents wants you to get the most out of your health insurance plan. One of the best ways to do so is to review your insurance plan carefully, so that you have a clear understanding of your and your child’s health insurance benefits. This will arm you with the information you need to be an effective partner with our office in managing your healthcare costs.
Chapel Hill Pediatrics’ Health Insurance Plan Participation
Insurance plans vary widely in the amount they pay for office visits, laboratory tests and procedures. Most insurance companies have a toll-free number on subscribers’ cards for help with questions about coverage.
We participate with most insurance plans. Your insurance coverage and benefits are a contract between you and your insurance company. Each plan has different benefits for you as well as different financial obligations. Not all insurance policies cover all services. It is your responsibility to check with your insurance company to determine covered benefits. We are required to file with your primary carrier only. It is your responsibility to file charges with any secondary insurance carriers for reimbursement.
We contract with the following Insurance Companies for your convenience:
- Aetna (excluding Duke Basic and Duke Select)
- Blue Cross Blue Shield, BCBS Federal, and BCBS Anthem plans (excluding Blue Local)
- Health Choice
- United Healthcare
- Private Health Care Systems
Our office will contact insurance providers and cooperate with them to help you receive your maximum insurance benefits. We participate in most health insurance plans offered in the Chapel Hill area. If you have a health insurance plan in which we do not participate, we will provide you with a completed claim form so that you can file for your benefits.
Billing, Deductibles & Copayments
Payment is expected at the time of service. This includes co-pays, co-insurance, and deductibles. Failure to produce payment at check-in may result in your appointment being rescheduled.
Some insurance plans do not pay for preventive health care, including physical exams. If you discover that your insurance company has rejected a claim based on your coverage, we cannot change the coding of the service performed in order to get the claim paid, as this is considered fraud.
Families who must meet yearly deductibles will be required to pay $75.00 at the time of service. A claim will be generated to your insurance company so that this amount will be credited to your deductible. In addition, we require a copy of your health savings account debit/credit card or a personal debit or credit card to remain on file in our office. Your card will be charged and a receipt generated once your insurance company sends us your explanation of benefits for the claim. If there has been an overpayment, we will issue you a refund check the following business day. If you do not place a Credit Card on file, payment in full is required on the date of service and a refund will be issued once your insurance company processes the claim.
For a more comprehensive overview of our practice’s payment policies, click on the link below to download a document with complete information on our billing and payment policies:
Feel free to contact our office if you have further questions about our health insurance and billing policies! Current patients can also log in using the fields on the patient portal to view outstanding balances on an account.