Insurance Participation

  • • Aetna
  • • BCBS
  • • Cigna
  • • Crescent
  • • Medcost
  • • Medicaid
  • • Tricare
  • • United Healthcare
  • • UMR
  • • Vaya Health

Medicaid Managed Care PHP’s

  • • Amerihealth Caritas
  • • HealthyBlue
  • • United Healthcare
  • • WellCare

Click each section for details:

  • If you participate in MediShare or another cost-sharing service we do not file these claims for you, as they are not insurance companies.
  • You will be considered as SELF-PAY at the time of service.
  • Upon your request, we can provide you with a detailed summary of services rendered.
  • Mountain Area Pediatrics offers a 15% discount to our selfpay patients if payment is made in full on the date of service.  This occurs when you check out at the end of the appointment.
  • Please be sure to bring your child’s insurance ID card with you to each visit.  If you have received a new card in the mail since your last visit, please let our front office staff know.
  • If you do not have current insurance information with you and we are not able to verify eligibility for your child, you will be asked to pay for services at the time they are rendered.
  • It is your responsibility to provide our office with any changes in insurance.  Insurance companies have a window of time in which we are allowed to file claims.  If we do not receive correct insurance information for your child within this time frame, your insurance company will deny the claim and the balance will be your responsibility.
  • SECONDARY INSURANCE:  Please make sure that we know if your child has a secondary insurance policy.
  • If your insurance policy specifies that you have a co-payment for office visits, we will collect this amount during the check-in process.  This must be paid on the date of service.
  • Please be sure to add your newborn to your insurance policy within at least 30 days of birth.
  • Contact the Mountain Area Pediatrics Insurance & Billing Department as soon as your newborn is active on the policy.  Until this takes place, you may receive a bill for any visits that have occurred since the date of birth.  Once Mountain Area Pediatrics receives the active policy information, we will bill these claims to your insurance company.
  • Please provide Mountain Area Pediatrics with the following information:
    • Insurance company
    • Subscriber name & date of birth
    • Member ID number
    • Group ID number (if applicable)
  • Bring your insurance card with you to each visit
  • Please check with your insurance company to confirm coverage of circumcisions. If this is a covered procedure, we will bill your insurance company.
  • If this is not a covered procedure cash & check payments can be made in person with the front office staff.  Credit card payments can be made over the phone or in person.
    • If paying with CASH, CHECK or CREDIT CARD the cost of the circumcision is $250
  • Once your insurance company has processed the claim, we will then send you a statement for your responsibility.
  • We accept CASH, CHECKS, and VISA/MC/AMEX/DISCOVER credit cards.
  • Payments may be made with the front office, via mail, by calling our Billing Office or via our website. You may receive an email from our billing team outlining your remaining balance with a link to make payments, as well.
  • Payment plans are available and arrangements may be made by contacting our Billing Office.
  • When utilizing our EARLY MORNING walk-in clinic, our AFTER HOURS evening clinic, or for visits on the WEEKENDS & HOLIDAYS, we charge a $30 fee.  **This fee may or may not be covered by your insurance company.**
Click Here to submit a secure payment through Phreesia

Important Announcements

MEDICAID TAILORED PLAN IMPLEMENTATION

The implementation of NCDHHS of Tailored Plans will go live April 1, 2023.

  • Patients need to ensure that Mountain Area Pediatric Associates is listed as your Primary Care Provider (PCP). This is VERY important.

  • MAPA is contracted with VAYA Health. Click here to find the most up to date information: NC Tailored Plans

Additional resources can be found here: Medicaid Transformation

NO SURPRISES ACT

In compliance with the No Surprises Act, Mountain Area Pediatrics will provide a “Good Faith Estimate” to uninsured (or self-pay) patients upon request. The “Good Faith Estimate” will help individuals estimate the expected charges they may be billed for receiving certain health care items and services.

More information from CMS can be found here: No Surprises Act

MEDICAID TRANSFORMATION TO MANAGED CARE 

Medicaid Managed Care became effective July 1, 2021.

  • Patients need to ensure that your MAPA physician is listed as your Primary Care Provider (PCP). This is VERY important.

Additional resources can be found here: Medicaid Transformation

  • Insurance and Financial Inquiries:

    Susanna (828) 350-3435