Insurances We Participate With Insurances We Participate With
 

AmeriHealth Mercy (MA)

Cigna

Gateway Health Plan (MA)

Health America

Highmark Blue Chip

Highmark Blue Cross/Blue Shield

Independent Blue Cross/Blue Shield

Pennsylvania Medicaid

United Health Community Plan for families (Commercial)

United Health Community Plan for kids (CHIP)

Univera

UPMC

UPMC for Kids

UPMC for You (MA)

And others...Please call our office

Insurances We Do Not Participate With Insurances We Do Not Participate With
 

Aetna Better Health Insurance

* We are not participating with all of the insurance plans offered under the Affordable Healthcare Marketplace.

Insurance Information Insurance Information
 

Your insurance policy is a contract between you and your insurance company.   We have contractual obligations with several PPO (preferred provider) and HMO (health maintenance) plans and will inform you if we participate with your insurance plan.  As part of this contract, we are required to collect all co-pays, deductibles, and balances.  Not every insurance company will cover all the services that we perform.  This office does not always know what different insurance companies will pay.  We will file insurance claims according to our agreement with the participating insurance plan if you provide us completed financial information forms and a copy of the insurance card for each covered member of the family.  We must receive the information within 30 days of the initial visit.  All charges will become your personal responsibility if completed insurance information is not provided or if eligibility cannot be determined.  By signing our financial statement, you are agreeing to pay for all coinsurance, deductibles, co-pays and non-covered charges that your insurance company deems are your financial responsibility. 

If you change insurance companies, it is your responsibility to inform our staff.  If you fail to do so and we file the claim with the wrong company, you could be responsible for the entire fee if the claim surpasses the filing deadline with the correct company.  If your insurance company does not pay the bill after repeated attempts by this office to file and obtain payment, the unpaid balance will become your responsibility.  If you are able to get the insurance to pay, you will be promptly refunded any amount due to you.

If both parents have insurance, the parent with the first birthday in the year is most often the primary insurer.  Please check your insurance policy to determine which company is primary before your appointment.  In divorce cases, we will bill the insurance requested, but the parent who brings the child in for services is ultimately the responsible party.

AFFORDABLE HEALTHCARE MARKETPLACE POLICIES

We are not participating with all of the insurance plans offered under the Affordable Healthcare Marketplace.  Each participating insurance company has their own policies and procedures that they do not necessarily share with the office.  Therefore, it is your responsibility to clarify that Warren Pediatric Associates is an in network provider on the policy you purchased through the Affordable Healthcare Marketplace.