Insurance & Billing
- Richmond Pediatrics will bill the insurance(s) you provide to us at the time of service.
- All copays are due the time of service.
- You are financially responsible for any outstanding balances after insurance payments.
- We will bill both your primary and secondary insurance carriers, provided they are contracted with us to do so.
- Please inform us of insurance changes as soon as possible. If claims are not submitted to the appropriate insurance in a timely manner, you may be responsible for the entire charge.
- If you currently do not have insurance, or insurance coverage cannot be verified, payment will be requested at the time of service.
- Insurance Cards – Please bring your most current insurance card to your child’s appointment, as this information needs to be kept updated to provide you with the most efficient billing service. Your current insurance card will indicate your co-pay, if any.
- Copays – We are required to collect all copays at the time of service and, by law, are unable to write-off a copay.
- Insurance Coverage – We participate with most Preferred Provider plans (see list below), but the insurance market changes frequently. We strongly encourage you to contact your insurance company to confirm that Richmond Pediatrics is covered by your plan.
- Well Child Checks
Please keep in mind that different insurance plans have different criteria as far as covering patient physicals. Some cover one per calendar year, while others cover one per benefit year, which doesn’t always coincide with a typical calendar year. We recommend that you contact your insurance company to find out what your specific benefit is.
PARTICIPATING INSURANCE PLANS*
**ATTENTION ALL UNITED HEALTHCARE PATIENTS - COMMERCIAL & MEDICAID**
Please be aware that certain United Healthcare plans are being switched to a Managed care plan, which means that our clinic would no longer be in network.
Some of these networks include but aren't limited to:
International Community Service
NPN (Northwest Physicians Network)
- Asuris NW Health
- Cigna Healthcare (Including Great West, Healthcomp)
- First Choice Network
- Kaiser Permanente — PPO Plans Only
- Please note: if you have the Kaiser Core or SoundChoice HMO plans we are NOT considered in network. You must be seen at a Kaiser Permanente clinic to be considered in network for their HMO plans.
- Healthcare Management Administrators
- MODA ODS Plus
- Molina Healthcare (Gold/Silver/Bronze)
- United Healthcare Tricare
- United Healthcare (Includes All Savers, Integrated Services, Medica, Student Resource and UMR plans)
- NPN (Northwest Physicians Network): We do not accept this plan.
- Workers Compensation (Please have all paperwork, claim number, and claim manager information at time of service.)
- Lifewise (Non-exchange plans only)
- Premera Blue Cross*
- Providence Health Plan
- Regence Blueshield — PPO Only
- Bridgespan UW Medicine, a Regence Plan, is not accepted here. Please contact a UW clinic
- Regence Group Administrators
- Regence UMP
- Coordinated Care
- Molina Healthy Options
- United Healthcare Healthy Options
(Please note that while we do accept Medicaid plans, we do not accept Community Health Plan of Washington or Amerigroup)
We accept the following plans from the Washington Health Exchange
- Lifewise Primary
- Premera Individual Signature, New 200 Heritage signature, Tahoma
Aetna: Hearing Tests
- Please note that the majority of Aetna plans do not cover Hearing tests as part of a well child check. We strongly urge you to contact your specific plan to verify your child’s preventive benefits. (Reference code 92552)
Premera EPO Plans:
- Richmond Pediatrics is NOT In-Network with Premera EPO plans. These types of plans are “individual plans” that are either purchased through the Health Exchange or through individual insurance. Please note this ONLY includes the EPO plans – we are still In-Network with all otherPremera Plans (non EPO).
- Please check with your insurance carrier if you think you might be on one of these plans. If you had to choose a PCP (Primary Care Provider) when you chose your insurance, or when you look at your card, you will see a place where it says PCP: and the name of your child’s pediatrician, you might be on a Premera EPO plan.
- Please let the Washington State Insurance Commissioner know if you have any concerns at 1-800-562-6900
- Please contact our billing department with questions about charges: (206) 546-2421, ext. 303 or (425) 899-3999, ext. 733 You can also email us at firstname.lastname@example.org.
- Please contact your insurance provider directly with questions about coverage.
Tip for New Parents:
We recommend adding your newborn baby to your health plan within the first week of the baby being born to avoid claims being denied.