Insurance Questions

Important Insurance Information

We realize that health insurance can be confusing and often frustrating. As your medical home, we want to clearly explain which services may and may not be covered by your insurance. While this will vary depending upon your policy, we will be happy to file your insurance claims and answer any questions you have about billing.We provide equal access to our services regardless of source of payment.

We currently accept the following insurance:

• Aetna
• BCBS PPO only
• Federal BCBS
• Cigna
• Choice Care PPO network
• Medicaid
• NCHealthchoice
• United

Insurance only covers the annual physical exam

The physical or wellness visit is only meant to be a screening visit with preventive measures in mind. This includes an opportunity to review your child’s medical history and look for potential health risks, to update their vaccinations and to assess their overall health and well-being.

It is important to understand that, according to your insurance, an annual physical or wellness visit does not include the evaluation and management of acute or chronic illness. This means that if your child is scheduled for a physical, service should be limited to that physical and not for evaluation of an ongoing illness like chronic asthma. Federal law and your insurance company make it necessary to split this part of your exam and therefore, keep it separate from the wellness benefit

Assessment of chronic conditions

If time permits, we will be happy to answer any questions or follow up on a chronic illness already being treated. However, depending on complexity, this may result in an office visit charge that is subject to a co-pay or deductible, depending upon your individual insurance policy. This is why we may ask you to return for a separate appointment. We will file any claim with your insurance company.

Lab work

Some insurance carriers do not completely cover the cost of lab work. Therefore, you may be responsible for any denied services to Triangle Pediatric Center or our laboratory partner, Labcorp.

Thank you for your understanding, and please let us know if you have any questions. As always we respect the confidence you have in allowing us to care for your family.