Insurance & Billing
We Accept Most Insurance Carriers
Pediatric Care North accepts most major insurance plans.
Please have your card with you at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.
Insurance Plans We Accept
ACA MARKETPLACE PLANS
- Aetna CVSHealth
- Anthem BCBS (Pathway & Pathway X)
- BlueKC (BlueSelect Plus & Preferred Care Blue)
- BCBS Kansas (BlueChoice)
- Medica (Medica with MU HealthCare, & Select by Medica)
COMMERCIAL PLANS
Anthem BCBS of Missouri (utilizing BlueKC network)
Ascension(utilizing BlueKC network)
- Ascension Personalized Care EPO (Out-of-Network)
- Blue Access (Out-of-Network)
- BlueCard PPO (plans with PPO suitcase on ID card)
- BlueSelect (Out-of-Network)
- BlueSelect Plus
- High Performance Network
- Freedom
- Freedom Network Select
- Preferred Care
- Preferred Care Blue
- Preferred Health Professionals
BCBS of Kansas BlueChoice Solutions (formerly BCBS Kansas Solutions)
Cigna (including Great-West Healthcare)
- Cigna + Oscar
- Cigna Plus
- Cigna SureFit
- HealthPartners
- LocalPlus or LocalPlusIN
- MVP Health Care
- Network Open Access
- Open Access Plus
- PriorityHealth
- Simple Choice (formerly Cigna Connect)
- Tufts Health Plan
- EPO Exchange (Out-of-Network)
- CoxHealth Plans (utilizing First Health Network)
FAIROS (powered by OccuNet)
GEHA (utilizing UHC network)
HealthLink PPO (utilizing Freedom Network)
- Balance by Medica (Out-of-Network)
- Medica Choice National (utilizing the First Health Network)
- Medica Connect (utilizing ProviDRs Care network)
- Medica with MU Health Care (referral required)
- Select by Medica
Mercy Health Springfield Communities
MultiPlan (excluding all health and/or cost sharing ministries)
National Preferred Provider Network
Orscheln Industries (utilizing HealthSCOPE TPA)
PHCS (excluding all health and/or cost sharing ministries)
ProviDRs Care (formerly WPPA)
QuikTrip
United Healthcare (UHC)
- ACA Exchange [Gold, Silver, Bronze] (Out-of-Network)
- All Savers
- Custom Network Plan (Out-of-Network)
- Deere Premier (Out-of-Network)
- Surest (limited benefit coverage)
- UHC Core Essential
- UHC Choice & Choice Plus
- UHC Navigate
- UHC NexusACO
- UHC Options
- UHC Select
- UMR
WellFit (utilizing Centrus Health)
FEDERAL PLANS
Tricare/Health Net Federal Services
- East and West plans
Billing FAQs
CO-PAYMENTS AND DEDUCTIBLES
All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.
PROOF OF INSURANCE
We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
CLAIMS SUBMISSION
We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
COVERAGE CHANGES
If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.
PAYMENT OPTIONS
Pediatric Care North accepts cash, personal checks, credit cards (Visa, Master Card, Discover and American Express). We also offer a flexible payment plan. Please see our Financial Coordinator for details. We are happy to file insurance for your reimbursement as long as you are free to choose your own pediatrician.
NON-PAYMENT
Unless arrangements have been made with our billing office, all accounts are to be paid within 60 days. Patients with an outstanding balance more than 90 days overdue MUST make arrangements for payment PRIOR to scheduling appointments. We realize that financial difficulty is a reality, therefore our Billing Department is available to assist you Monday through Friday 8:00 am - 4:30 pm. The direct phone number for our billing/insurance office is 816-587-3341.
