Billing & Insurance

All gynecological services are paid at the time of service unless we have a contractual agreement with your insurance company (see list).  Since there are hundreds of insurance plans, we ask our patients to make sure you are familiar with your own healthcare coverage and its limits.  We are, of course, happy to submit claims for those plans with which we are contracted.  However, the basic responsibility for payment lies with the patient.

If your insurance company requires a co-payment for visits, you must pay at the time of service.  We provide a variety of payment options by accepting American Express, VISA, MasterCard and Discover, in addition to cash or check. For your convenience, you can now pay your bill online, just simply click the tab on the left and take care of business in a secure site - your financial privacy is securely protected.

Please bring your current health insurance card with you at the time of service.  We cannot file insurance without a current insurance card and this could result in rescheduling your appointment.

WELLNESS AND WHAT CAN I EXPECT

Having a wellness or yearly health care visit is a great opportunity to take charge of your health. Routine health care visits can help find problems early or prevent health problems before they occur. If problems are found early, they may be easier to treat and less likely to pose serious risks to your health. Preventive or Wellness health care includes the following:

  • Discussion of health topics relevant to your age and risk factors
  • Exams
  • Discussion regarding screening tests and immunizations (however, these may not be covered by your insurance carrier)

There are new guidelines regarding Pap smear screening. It is important to remember that a wellness or yearly health care visit is recommended, even if it's not time for your Pap smear. A Wellness Visit includes: a physical exam including evaluation of your height, weight, blood pressure, urinalysis, breast exam and pelvic exam, but you may or may not have a Pap smear, based on the guidelines below and discussion with your doctor, nurse practitioner, or certified nurse midwife.

IMPORTANT NOTE: Some insurance carriers consider annual based on the exact date you were seen in the past year, other carriers allow an annual anytime during a calendar year. Please check with your plan prior to scheduling your annual visit to determine their guidelines.

Pap Smear Facts

  1. A Pap test and pelvic exam are important parts of a woman's routine health care because they can detect cancer or abnormalities that may lead to cancer of the cervix.
  2. Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer.
  3. Guidelines from the American College of Obstetricians and Gynecologists recommend that women begin Pap test screening at age 21, be screened every 2 years through age 30, and then be screened every 3 years as long as their last 3 results have been normal.
  4. If the Pap test shows abnormalities, further tests and/or treatment may be necessary.
  5. Women who have been vaccinated against HPVs still need to have Pap tests.
  6. Women ages 65-70 years old who have had at least 3 normal Pap tests and no abnormal Pap tests in the last 10 years may decide, after talking with their doctor, to stop having Pap tests.
  7. Women who have had a hysterectomy (surgery to remove the uterus and cervix) do not need to have a Pap test, unless the surgery was done as a treatment for a precancerous condition or cancer.

PLEASE NOTE:
Any other testing: lab's/referrals/ultrasound ordered based on signs/symptoms you share or are noted at the time of your wellness visit may not be covered as part of the wellness visit and you may be financially responsible.

References:
National Cancer Institute 12/21/2010
American College of Obstetricians and Gynecologists (ACOG) 2012; 11/2009

Labs

Many insurance carriers dictate the facility to be used for labwork, pathology and therefore you may also receive a bill from one of these outside sources.  Please check your plan coverage to determine the facility and inform the lab technician to avoid unnecessary costs to you.

Billing for Obstetrical Care 

Our goal is to make the financial aspect of your pregnancy as painless as possible!  During the first few weeks of your pregnancy, we will verify your eligibility and coverage benefits with the insurance carrier.  Please note: THIS IS NOT A GUARANTEE OF PAYMENT.  We recommend you contact your insurance plan personally to confirm the information.  If your insurance coverage changes during your pregnancy, it is your responsibility to notify the business office as soon as possible.

Usually by the second visit to our office, we will inform you of your financial obligation to our office.  This amount reflects the portion of your bill we estimate the insurance will not cover.  This is only an estimate.  The total amount of your financial obligation must be paid before the beginning of your seventh month.  If it is necessary for you to leave our practice, you will be billed for all care provided up to the time of your departure.

Our Fees

Fees for a normal, uncomplicated pregnancy are based on prenatal visits, delivery and a 6-week post partum check.  The pre-operative exam and two follow-up visits are also included in the charge for a Caesarean Section delivery.

What our fees include

Our fees include the initial and subsequent history, physical examination, recording of weight, blood pressures, fetal heart tones, routine monthly visits up to 28 weeks gestation, biweekly visits to 36 weeks gestation and weekly visits until delivery.  The fee also includes delivery and postpartum care.  Included also is an extensive education packet and a detailed visit with a certified nurse-midwife to provide review history and lab results, provide education and develop a plan of care for your pregnancy.

Our fees do NOT include

  • Fetal Non-stress tests
  • Blood work, lab tests, pap smears, etc.
  • Office calls for non-pregnancy related care
  • Anesthesia during childbirth
  • Hospital charges
  • Circumcision
  • Newborn hospital care
  • Ultrasound
  • Infant Care after delivery

Please contact our business office if you need further information. We recommend you contact the Financial Department at Piedmont Fayette Hospital at (770-719-6811) or Piedmont Newnan Hospital at (770-400-2707) if you have questions about their charges.

 

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