Insurance
Lincoln Pediatric Group participates with most major insurance plans in our area.
Please call our office prior to your visit to make sure that we are in network with your insurance plan. We will file your insurance claims for you if you have provided us with your current insurance information. To ensure claims are processed under the current policy, we will ask to see and/or copy your insurance card at each visit. We are also required to collect your co-payment at the time of service. If you do not have insurance, payment in full is due at the time of service. For your convenience, we accept cash, checks, MasterCard, Visa, Discover and American Express.
Immunizations are an important part of your child's health. They are also very expensive, and can cost hundreds of dollars. If you do not have insurance coverage for immunizations and you choose to have your immunizations at our office, we require payment in full prior to administering the immunizations. If immunization cost is a concern for you, the Lancaster County Health Department offers these same immunizations at a greatly reduced cost if you qualify. You can call them at 402-441-8065 for more information. Please feel free to speak to someone in our billing department at 402-489-3834 option 2 for further information about immunization payment.
You will receive a statement monthly as long as you have an unpaid balance. You are only billed for services which have been processed by your insurance company or for which no more insurance payments are available. The amount you owe is listed as “patient balance” on the statement and is due upon receipt of the statement. Please contact our billing department if you are unable to pay in full upon the receipt of your statement so that we can inform you of our payment plan options through Phreesia and our partnership with Union Bank and Trust.
We participate with most local and many national insurance plans.
However, it is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive.
If you provide complete and accurate information about your insurance, we will submit claims to your insurance carrier and receive payments for services. Depending on your insurance coverage, you may be responsible for copayments, coinsurance, or other deductible amounts.
Please contact our billing office or call your insurance carrier should you have questions.
Insurances We Accept
At Lincoln Pediatric Group, we accept a wide range of coverage and insurance plans, including:
- Aetna
- Auxiant
- Blue Cross Blue Shield
- Cigna
- Midlands Choice Plans
- United Healthcare, UMR
IMPORTANT! These are the main companies we accept but there are various other small companies we accept as well, please call our office with any additional billing & insurance questions.
| Market Place Products: | Medicaid of NEBRASKA: |
|---|---|
| AMBetter | Molina |
| Bright Health | Nebraska Total Care |
| Medica | UHC Community plan |
| Oscar |
We are currently not accepting new patients who have Medicaid. Please watch our website for updates. We apologize for any inconvenience this may cause.
Do you file my claims with my insurance company?
We will file your primary and secondary insurance claims for you as a courtesy if you have provided us with your current insurance information. If you have a claim for a motor vehicle accident or worker's comp, please notify our billing staff and they will send a printed claim to your home address.
If I am unable to pay my balance due in full when I receive my statement, what are my options?
Please contact our billing department if you are unable to pay in full upon the receipt of your statement so that we can inform you of our payment plan options through Phreeisa and our partnership with Union Bank and Trust.
What is G2211?
Medical offices get paid by “coding” what they do. These codes are designated by the Center for Medicaid and Medicare Services (CMS). A new code – G2211 – has been created by CMS for primary care providers to indicate that they are following patients longitudinally and are committed to caring for the “whole patient” over time. This code is needed to account for the complexity and added resource costs of providing truly comprehensive primary care. This code is not related to a clinical condition. Instead, it refers to the long-term nature of the practitioner-patient relationship. Unlike urgent cares and emergency rooms, Lincoln Pediatric Group (LPG) is a medical home and takes pride in offering this type of care to your child(ren). As such, we will be adding this code to all permitted visits, which excludes annual physicals (well visits). Unfortunately, many insurance companies are not paying for all the services we provide, even if CMS says we need to document and code for what we do. Some carriers will completely deny payment. Others will pass the charge on to the patient. We are not happy with their position, and feel it is unfair both to us and to you. But, per our contracts with the insurance companies and complying with CMS, we must continue to code for services as instructed. If you receive a bill for this code, G2211, we will not be able to waive the charge. Instead, we ask that you follow up with your insurance carrier directly for reimbursement. We take great pride in providing your child with the highest quality of care possible. Documenting and coding appropriately for the services we provide is necessary for us to continue to serve our families in this way.
What is "coordination of benefits"?
Most insurance companies will send questionnaires to you periodically requesting information on whether or not you have additional insurance coverage for your child. This process is called "Coordination of Benefits". One of the major reasons for delays in insurance processing is the need for insurance companies to receive this information from you on a timely basis. If you receive a request for information, it is very important that you complete and return the forms promptly.
When do you expect payment after I receive my statement?
The amount you owe is listed on the last page in the box labelled "patient balance". Lincoln Pediatric Group expects you to pay the "patient balance" upon receiving your statement.
When is your billing staff available to answer billing questions?
Our billing staff is available from Monday to Friday between the hours of 8:00 AM and 4:30 PM.
When will I receive a statement?
You will receive a statement monthly as long as you have an unpaid balance. You are only billed for services which have been processed by your insurance company and for which no more insurance payments are available.
Why do I need to show my insurance card at each visit?
Providing us with your insurance card at each visit will ensure all your claims are processed under the current policy number and are mailed to the correct insurance company at the correct claims processing address.
Will my child's immunizations be covered by my insurance company? If not, what are my options?
Immunizations are an important part of your child's health. They are also very expensive, and can cost hundreds of dollars. If you do not have insurance coverage for immunizations and you choose to have your immunizations at our office, we require payment in full prior to administering the immunizations. If immunization cost is a concern for you, the Lancaster County Health Department offers these same immunizations at a greatly reduced cost if you qualify. You can call them at 402-441-8065 for more information. Please feel free to speak to someone in our billing department at 402-489-3834 option 2 for further information about immunization payment.
Will there be a co-pay for each visit?
We encourage you to contact your insurance company prior to your visit if you have any questions regarding your co-pay. Your co-pay is determined by your insurance company. Although Lincoln Pediatric Group does not set the amount of your co-pay, we are required to collect the co-pay at the time of service if one is due.