Raleigh Office

(919) 872-0250

Garner Office

(919) 779-6423

After Hours

(919) 831-5394

Insurance and Billing

Insurance and Billing

By contracting with these companies, Raleigh Pediatrics has agreed to file insurance for patients who participate in these plans. In order to do so, we must see your child’s insurance card at each visit and if you participate in a managed care program, one of our physicians’ names must appear on the card. If you do not have the necessary information and we are unable to verify your coverage, we must ask for payment at the time of the visit.

We collect all co-payments at the time services are rendered and file insurance on a daily basis. A monthly statement will be sent to you detailing unpaid charges. If you have questions regarding items which have not been paid by your insurance, we ask that you contact your insurance company or employer as benefit packages vary by employer.

 

Updated 11/19/2020


SELF PAY — If you have an insurance with which Raleigh Pediatrics does NOT contract, your account will be considered Self Pay. You must pay in full at the time of service and file your own insurance. No insurance adjustments will be made to these accounts. (1/2021)


Raleigh Pediatric Associates will participate with the following insurance carriers effective January 2021:

NEW  2021 ACA EXCHANGE PLANS: (1/1/2021)

  • BRIGHT HEALTH
  • CIGNA CONNECT
  • UHC COMPASS

CONTRACTED INSURANCES:

  • Aetna  
  • Blue Cross & Blue Shield of North Carolina
    • Including:
      • BCBS NC State Employees Health Plan
      • BCBS Federal Employees Health Plan
  • Cigna Healthcare
    • CIGNA EXCEPTION: Raleigh Pediatrics does NOT participate with Cigna Indemnity plans.   
  • MedCost PPO
  • United Healthcare
  • New WakeMed Employee Plan via Contigo Health
  • Medicaid  / Carolina Access / NC Healthchoice*
    • Only accepting Patients who meet the following qualifications
      • New patients TWO months of age and  younger
      • *Established patients and **their siblings
*A patient is considered established only if they have been seen by one of our physicians in the last 3 years and have not transferred out of the practice. 
** Siblings include Adopted, Foster and Legal Guardianship 

Please check the Financial Policy for the exceptions and additional insurance information.

Make a payment here.


Routine Screening Tools:

The physicians of Raleigh Pediatrics perform comprehensive well exams on their patients following the Bright Futures (American Academy of Pediatrics) recommendations.  These recommendations include timing of the exams along with appropriate testing, screening and lab work.  It is possible that some portion of the exam may not be covered or may be applied to a deductible by your insurance company and then would be your responsibility.  While we are sensitive to costs, we believe all of these screenings are necessary to provide the best care for your children.

Examples of routine screening tools used at well visits include

  • General Screenings: Vision, Hearing, TB screen, Lead Screen
  • Developmental screening tools: M-Chat – Autism screening tool (routinely done at 18 months and 2 years), PEDS Response – Parent evaluation of development status (at intervals between 6 months – 5 years)
  • Behavioral and Psychosocial screening tools: EPDS – Edinburgh Postpartum Depression Screening (routinely done at 1 month, 2 month, 4 month and 6 months well exam), RAAPS – Rapid Adolescent Assessment for Preventative Services done annually 11 years through 22 years

 

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