Accepted Plans and Payment Policy

ACCEPTED PLANS

We accept most major medical plans as well as Nevada Medicaid; we have listed a few for your reference. Please note this list does not represent all health insurance plans that we accept. If you do not see a specific plan, please give our office a call and one of our insurance specialists will be more than happy to answer any questions you may have.

We are happy to announce that we now accept regular HPN HMO as of September 1st, 2016. Just give HPN a call to select us as your PCP and that’s it. Give us a call if you have any questions. *** We’ve had reports of HPN advising our patients that we are not in-network. This problem is being investigated.  We are absolutely in-network with HPN HMO, HMO Exchange, Smartchoice Medicaid and Sierra Health & Life PPO. Please let us know if you have any problems selecting our office as your PCP.*** 2/27/17 

Commercial

Aetna (PPO, POS, HMO-we must be the PCP)

Aetna Forms: Coordinatin of Benefits Form

Anthem BC/BS (Non-Pathway Plans)

Teachers **NEW CHANGES** We must now be selected as your PCMH / PCP

Teachers Forms: Provider Change Form ;    Coordination of Benefits Form ;   2017 Plan Documents Benefits

Cigna (Non Local Plus)

United Health Care

HPN (PPO or POS)

HPN (HMO Exchange

HPN (HMO)**NEW**  We now take regular HPN HMO effective 09/01/2016

UMR

Prominence (Formerly St. Mary’s)

Culinary Health Fund

 

Nevada Medicaid – Please note for Medicaid Managed Care Plans (HMO) we must be the selected PCP before care can be rendered.

NV Medicaid

Smartchoice

Amerigroup

 

Plans not accepted

Cigna “Local Plus”

Tricare

Anthem BC/BS “PATHWAY

Out of State Medicaid

Culinary HCP (Must see HealthCare Partners only)

Aetna Exchange

 

 

PAYMENT POLICY

Thank you for choosing Wee Care Pediatrics for your child’s medical care. The following is an explanation of our payment procedures and office policies.

Payment is due at the time of service. We do not bill for deductibles or co-pays. We accept cash, Visa, MasterCard, Discover and American express. We do not accept personal checks. Patients utilizing our cash pay program must pay before each visit.

The parent or guardian who brings the child for their visit is responsible for payment at the time of service. We do not intervene between divorced parents or in the matter of custody issues– reimbursement will need to be between parents or guardians.

Appointments must be cancelled within 4 hours of the scheduled time in order to avoid a $25.00 No Show Fee. We never make appointments without your consent. We will give a courtesy call the day prior to your appointment. Ultimately it is your responsibility to keep your contact information current and to cancel any appointments you will not be able to attend. (Fee increases to $45.00 June 1st, 2017)

Account balances must be paid prior to any future visits. If there is an account balance due and you come in for an appointment, a payment must be collected and payment arrangements must be made before being seen. Emergent cases will be considered

Account balances that exceed 90 days past due are sent to an outside collection agency. You will be responsible for all collection and legal fees that accrue by the outside agency. Payment must be made before any future appointments.

We will gladly bill your primary and or secondary insurance for you. It is your responsibility to keep your Coordination Of Benefits current with your insurance providers. Failure to do so may result in lack of payment from your carriers. We are not responsible for non-payment from your insurance carrier due to missing COB’s and any balances will become subscriber responsibility due in full.

Any patient that is covered by a commercial health plan and Medicaid, your commercial plan will always be primary. Failure to disclose a commercial health plan when the patient is covered by Medicaid falls under Nevada Medicaid Fraud and Abuse. Any balances that are incurred due to concealing a primary commercial health plan and COB will be the financial responsibility of the parent.

In order to bill your insurance company, we must have an up to date insurance card. If we are unable to verify your insurance coverage, you will be considered a cash pay patient.

Most importantly, Wee Care Pediatrics wants the best care possible for your child and we understand you may have certain financial difficulties. Please feel free to discuss any financial matters with our billing department.