Parents of Peachtree Park Pediatrics,
Many families change health insurance at the beginning of the year. If you have new coverage, please make sure your child’s doctor is listed as the PCP (if applicable) and bring the current insurance card to the next visit.
We know that some of you purchase your family’s coverage on the Exchange/Individual Market Place.
Many of the insurance companies that left this market a few years ago due to decreased profits chose to re-enter the market for 2022. When you made your plan selection in late 2021, you likely did your due diligence to see if your physicians and providers were in network. Unfortunately, through insurance company error, some of our physicians were incorrectly listed as in network with some insurers- something we had no knowledge of.
Historically, Anthem BCBS was the only well-known commercial insurer who remained in the Exchange. Several plans, including CareSource and PeachState/Ambetter, operate Medicaid Care Management Organizations in Georgia and we have never shown as in-network for those market plans. Kaiser Permanente has also been offered in the market for several years and we are not in that network.
Our contracts with the “big” plans like United, Cigna and Aetna are only for their commercially offered employer-based plans. In January 2022, we formally contracted with Anthem BCBS to include their Exchange Pathways market product.
As of 2022, regardless of what their website or customer service representative might say, we are not in network for any of the United market products or the Cigna market products (like Oscar).
If you have chosen one of these plans, we cannot file these claims for you. Even if you submit the claim yourself, there is a good chance it won’t be covered since many of these plans require you see your PCP (Primary Care Physician). We can offer you a discount on the office visit charge when paid at the time of service, but we cannot discount vaccines or procedures.
It is unfortunate that this issue occurred. When you enroll for 2023 you may have these same choices or there may be different insurance companies offered. Or, at some point, our status could change if a contract for these plans is completed.
If you have questions, please feel free to call our office and ask to speak with Donna Scowden.
We encourage everyone to continue to use good hand hygiene and practice social distancing as much as possible. Please contact our office with any further questions or concerns.
Peachtree Park Pediatrics
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Peachtree Park Pediatrics strives to deliver up-to-date primary care to our infant, child, and young adult patients in a welcoming and family-friendly environment. The practice has deep roots in the Atlanta community, and it is our continued honor to be entrusted with the health care of our next generation.