Billing and Insurance Information

Billing and Insurances:

To speak with someone from our billing department directly at (301) 517-9712 or email inquires to [email protected]. If you reach voicemail during business hours, please know our staff is either on the phone with an insurance company or assisting another family. Please leave a detailed voicemail or send us a detailed email so that we may assist you faster.

Insurances Accepted:

Aetna – HMO, PPO
Aetna Better Health (Medicaid MCO)
Amerigroup (Medicaid MCO)
Carefirst Administrators
Carefirst Blue Cross Blue Shield – HMO, PPO, FEP
Carefirst Community Plan (Medicaid MCO)
Cigna – HMO, PPO (GreatWest)
Coresource (Aetna and Cigna Network)
First Health Network (Coventry & Adventist Healthcare)
Golden Rule
Humana Military
John Hopkins EHP
John Hopkins Family Health Plan
Maryland Medicaid (Red & White) REM
Maryland Physicians Care (MCO Medicaid)
Meritain Health
Priority Partners (MCO Medicaid)
United Healthcare Community Plan
United Healthcare – HMO, PPO,

If your insurance company does not appear on the list above, or you want to confirm participation with your insurance, please contact our office. We cannot guarantee payment from any insurance company. It is the policyholder’s responsibility to verify if the provider is in-network with their insurance. If we do not participate with your insurance, you may still join our practice; however, you will be required to pay
fee-for-service at the time the services are rendered.

While this office will verify your insurance policy coverage prior to your appointment, we advise that you contact your insurance company for any concerns you may have. Please familiarize yourself with the specifics of your insurance policy including coverage benefits and limitations. Information provided to us is not a guarantee of payment, all benefits are subject to plan provisions by the insurance company. Should you receive or request a test or procedure that is not covered by your insurance plan, any unpaid charges will become “patient responsibility”.

Our billing staff is available Monday through Friday 8:15am-12:00pm & 1:00pm- 5:00pm, to discuss your account and any questions you may have. To reach the billing department directly please call (301) 517-9712. You may also reach them via email at [email protected]. If you send an email, please allow 24-48 hours for a response.

Proof of Insurance:

Adequate proof of insurance is required at all visits; be prepared to show a current insurance card and photo identification. If adequate proof of insurance is not established prior to the appointment, you will be financially responsible for the entire visit at the time services are rendered. Guarantors should alert front desk staff of any insurance changes prior to being seen.

Primary and Secondary Insurance:

In some cases, patients may have more than one insurance policy which would be considered Primary and Secondary Insurance policies. There are several rules that indicate which policy is Primary and which is Secondary. The following are some of the rules that apply:

* Policyholder's date of birth.
* Policyholder's coverage date, and insurance company types.
* A coordination of benefits will need to be completed to ensure that the insurance pays adequately.
Please note that Medicaid will always be secondary to all commercial insurance plans/policies.

Policy & Insurance Terms:

Guarantor: Is the responsible person for all co-payments, deductibles, co-insurance, and unpaid charges on the patients' account. The guarantor is always the patient, unless the patient is a minor or an incapacitated adult. This person may be the policyholder in most cases.

Policyholder: Is the individual owner of the insurance policy and may or may not be the responsible Guarantor and in some cases is the patient.

Non-covered Services: a "non-covered" service may include services that are covered under the plan but are not reimbursed because of some contractual limitation for example, (a second well-child exams, when a plan covers only one per calendar year, pre-existing conditions, and certain diagnosis not covered by plan).

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