Insurance

It is required that you bring your insurance card to every appointment.

Health insurance is designed to help you meet the cost of medical services. Your insurance contract defines the specific limitations of your policy and it is always your responsibility to understand the coverage your insurance program provides and its referral authorization process. Please present all insurance information on your first visit to our office. We will assist our patients with insurance in any way we can. Patients are responsible for non-covered services and all charges until the deductible is met.

We are network providers with Blue Cross/Blue Shield, Tri-Care,  Medcost, Cigna, United Healthcare, Aetna, and NC Medicaid (including Healthy Blue, AmeriHealth, United Healthcare Community Plan, Wellcare, and Carolina Complete/Trillium). 

If your child is covered by Medicaid, you must present the card to the receptionist at every visit. As required by law you must inform us if your child has private insurance in addition to NC Medicaid. Medicaid requires private insurance to be filed first. Our clinic is a Carolina Access provider. If another physician is listed as your child's Carolina Access provider, the visit to our clinic must be authorized in advance. Likewise, if Carteret Children's Clinic is listed on your card as your Carolina Access provider, all visits to other providers must be authorized in advance by our office.

Well Visit Notice

During your well visit, our primary focus is on preventative care, ensuring your overall health and well-being. However, if a medical issue or problem is identified and requires additional evaluation or treatment beyond the scope of the well visit, your insurance may see it as a problem visit and it may be billed as a separate service. This could result in an additional charge, which may be applied to your deductible or copayment, depending on your insurance plan. We want to ensure that all your concerns are addressed properly and thoroughly. We make every effort to accommodate our families and address other concerns and issues during well visits as a convenience to our families to avoid additional visits. This is not always possible and may require you to schedule additional appointments.

Laboratory Test Notice

Insurance and healthcare are changing rapidly, and we understand that your insurance benefits can be confusing.
We are finding that insurance companies that have paid for laboratory testing in the past are now being much more selective about the type of tests that they are paying for. It is also becoming more and more common that patients have high deductible insurance plans and are therefore responsible for larger portions of their bills. Lab tests are often above and beyond your office visit and not included in your copay.
Please understand that we cannot know which tests are covered by your individual insurance or what your insurance will send to your deductible. Often your insurance may "cover" a lab or procedure, but this does not mean they will pay for it. It may go to your deductible or coinsurance. We recommend that you review your policy and if in doubt contact your insurance company prior to the lab test being done.
In addition any laboratory testing that is collected in our office, but sent to an outside lab for processing will be billed separately by the facility that performs the testing. This includes cultures, PCR panels and other tests that are collected at our office, but are sent to an outside facility for testing.
Be assured, our interest is solely in providing modern, up to date, quality care for your child. If you have any questions, please let us know.