Insurance & Billing

Insurance Participation

Trusted Doctors participates with most major insurance plans. For your convenience, we have listed them below but it is always best to contact your carrier directly before being seen. We recommend you familiarize yourself with the your deductible, maximum number of well visits (first year of life and after), and participating laboratory.


We will be happy to see patients with other types of health insurance. However, when we do not have a contractual arrangement with an insurer, payment for services is expected on the day it is delivered. We can provide documentation that you can submit to your insurer for reimbursement. Please call the Trusted Doctors Billing Team at (888) 969-3735 with insurance specific questions.

Painting of a bird's nest with eggs in it on a leafy tree branch

We participate with the following insurance products

  • Aetna (HMO and PPO)
  • Aetna Innovation Health
  • Aetna Signature Partners
  • Anthem (HMO and PPO)
  • Care First (HMO and PPO)
  • CHAMP VA (Courtesy File)
  • Cigna (HMO and PPO)
  • Cigna Connect
  • First Health/PHCS
  • Humana
  • John Hopkins (US Family Health and EPHC)
  • MediNcrease
  • Multiplan
  • Prime Health Services
  • Sentara Health Plan
  • Sentara Community Plan (Medicaid MCO)
  • Student Resources (UHC)
  • Tricare
  • United Healthcare (HMO and PPO)
  • Virginia Health Network
  • Virginia Medicaid
  • Web TPA

We do not participate with the following insurance products

  • Aetna Better Health of VA (Medicaid MCO)
  • Anthem HealthKeepers Plus (Medicaid MCO)
  • Department of Veterans Affairs 
  • Kaiser (HMO)
  • Magellan Complete Care of VA (Medicaid MCO)
  • Molina (Medicaid MCO)
  • Sentara Community Plan Kaiser
  • United Healthcare Community Plan (Medicaid MCO)

Billing Information

Our policy is to scan a copy of your insurance card upon arrival. We update those scans each visit, and sooner if your insurance changes in any way. When your insurance information is out of date or missing on the day of your visit, we may not be able to submit your insurance claim in time to meet your insurance carrier deadlines and you will be billed for the total amount due. Ensuring that we have your up-to-date insurance on file avoids this!


Co-pays are due at the time of service.  If you have verified insurance on file with us, your carrier will be billed first. If there is a remaining balance after the insurance payment, you will be sent a statement. Self-pay patients are expected to pay their bill at check-out on the same day. We accept most typical forms of payment and all major credit cards. Your timely payment is appreciated.


We are understanding that not everyone has insurance. We refer to these patients as Self-Pay patients and they are billed in accordance with this. Please click this link to our Self-Pay form if you have any questions regarding this: Self-Pay Form


  • Information regarding Wellness Visit Appointments:

    Many families request additional services or treatments during a child’s wellness visit.  Our office does not want you to be surprised by a bill and wants to share that all services or treatments provided are billed following federal and industry standards and guidelines.


    A wellness visit includes:

    • Assessment of overall health and wellbeing
    • Update on vaccinations
    • Preventive screening services such as developmental screens (ASQ, MCHAT), behavioral screens (PHQ-9, EPDS), environmental screens (SEEK), hearing / vision screenings, and blood tests based on the standard of care for each age.  Additional charges apply for these tests.

    Some families want only these recommended preventative services at a “well child” visit and would prefer addressing problems like a new illness, mental health issues, and medication checks at a separate appointment.  Other families appreciated that the pediatric provider may be able to provide additional care at the same time to avoid another trip to the office.  Please note that if additional health issues are discovered during the wellness visit they cannot be ignored.


    If time permits, we often extend your wellness visit to address new or ongoing problems, however, please note that when additional services or treatments are provided it will likely result in your insurance plan determining that the visit is subject to a co-payment, deductible, and/or co-insurance.


     

  • Information regarding Send Out Laboratory Testing:

    If your insurance company requires you to use a particular lab, you need to inform our staff of this prior to any blood draws or specimen collection.  If you are unsure of your lab coverage and do not want to proceed with the test, please inform our staff immediately and contact your insurance company directly for more information.


    Piedmont Pediatrics works with the University of Virginia Laboratory, Sentara Martha Jefferson Hospital Laboratory, and LabCorp for lab tests that we cannot perform in house.  The lab company will bill you directly.  If you have questions about a fee from a lab company please directly contact the lab company who issued the bill.