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Insurance Participation
When you sign up for your insurance coverage, please make sure you read the rules and select the plan carefully. Once you hae signed to contract, you have agreed to follow its rules and regulations. Make sure you understand the following:
- Which doctors and hospitals participate with your insurance. Insurance companies sign contracts with hospitals and doctors for their members care. These doctors that agree to follow the insurance plans are called the plan's network. Your insurance company might not pay if you go to a provider outside of the plan's network. If your insurance mandates the selection of a primary care provider, you must choose a doctor prior to your first office visit. If you do not choose before your first visit, it may result in non-payment by your insurance company and you will be responsible for the services provided.
- Rules for seeing specialists. Many plans will not pay for you to see a specialist without a referral from your primary care provider. If you see a specialist witlhout a referral, you might have to pay for the visit. Please make sure the specialist participates with your insurance plan.
- Prescription Medicines Every insurance company has a list of approved medications that they will cover. If a medicine is not in their approved list, they might refuse to pay for it, or you will have a higher co-pay. Sometimes they will require a pre-authorization from your provider.
At South Riding Family Medicine we participate in many managed care plans and see patients with traditional insurance. See the detailed list of plans below for your reference. Many plans require that you make a co-payment at the time of your visit. To make it as easy as possible for you, we accept cash, checks, and most major credit cards at our office.
Our practice administrator, Pat Rogers can answer many of your insurance questions. Please bring your insurance card with you for each visit and notify our front desk anytime your insurance coverage changes. We participate with the following plans:
Aetna US Healthcare
(non-HMO Products) PPO, MC, EPO, Prudential plans.
www.aetnaushc.com
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MAMSI
(Alliance PPO, MDIPA Preferred (POS),
MDIPA HMO, Optimum Choice Preferred
(POS), Optimum Choice HMO, MAMSI Life
& Health (Indemnity))
www.mamsi.com |
CareFirst Blue Cross/Blue Shield
(Capital Care HMO, Capital Care Advantage HMO, Capital Choice HMO)
www.carefirst.com |
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CareFirst Blue Cross/Blue Shield
(Blue Preferred PPO, BC/BS Indemnity)
www.carefirst.com |
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Trigon Blue Cross/Blue Shield
(HealthKeepers HMO, PPO-Key Advantage,
Cost Alliance, BC/BS Indemnity)
www.trigon.com |
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Private Healthcare Systems - PHCS
(Fortis, Guardian)
Effective 10/01/01
www.phcs.com |
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Workmans Compansation |
TRICARE |
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Medicaid
(note: We are not accepting new
Medicaid patients. We are only
accepting established patients we
have seen under medicaid before.)
www.hcfa.gov/medicaid/medicaid.htm
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