Medical services are provided and billed by For Women, PA. We do our billing through Unified Physicians Management and have an in-house billing specialist to help with your questions and concerns. We participate with most all of the major health insurance plans in the region. Below are the health plans which we currently accept.
If your plan is not listed, we will be unable to file a claim on your behalf. However, we can provide you with a form that you can submit to your insurance company to instruct them to send reimbursements directly to you.
Please be aware that with any health plans, there may be deductibles and copayments for which you could be responsible. Please be prepared to pay these at the time of your visit.
We are in network for MOST
BCBS including Blue value and Blue local
Aetna (existing patients)
Although we are not in network with Medicare and Medicaid, we are happy to see any patient in those plans and do offer a patient cash pay discount.
If you have one of these plans, your labs, diagnostic testing, x-rays, and hospital services can be covered by insurance, only the doctor's visit will have to to be paid for out of pocket. Our office is happy to provide you with a previsit estimate.
If you have a Medicare secondary plan we are happy to submit claims for you to reimburse you for the cost of that visit.
To our valued patients- it has come to our attention (from the survey) that there are Important Billing Changes / Clarifications that you might like to know.
1. As for January 1, 2018, many lab tests are no longer covered by Insurance when done as part of an annual visit regardless of what diagnosis code is used. Some examples are: urine tests, hormone tests, vitamin tests, and thyroid tests. Some tests that are usually considered part of the annual exam include: lipid panels, Diabetes screening, STD screening, anemia testing and Pap smears every 1-3 years. Please check with your insurance plan regarding your individual coverage.
2. Our office charges $15 for a venipuncture, specimen handling, and processing. As of 1/1/18, Blue Cross stopped paying our practice for this service. If you have Blue Cross and you want your insurance to pay for this service you will need to go to LabCorp for your blood draws. You can visit https://www.labcorp.com/ to find the nearest drawing site. We can arrange to send orders to the lab.
3. Questions submitted via the portal should be limited to requests for medication refills, simple questions about already established care plans, currently prescribed medications, recent lab results, and complications of any treatment. Such questions requiring less than 5 minutes will be at no charge. More complex questions will require billing. New problems or multiple questions will require a visit/fee. The portal is checked M-F during office hours.
4. Annual gyn wellness exams (as defined by insurance companies) do not include the management of multiple problems (see below.) For evaluation and management of new problems or detailed review of chronic conditions you may be charged a copay/ coinsurance or be asked to schedule a separate appointment.
WHAT IS AND WHAT IS NOT CONSIDERED INCLUDED IN A GYN ANNUAL WELLNESS VISIT AS DEFINED BY THE INSURANCE INDUSTRY
An annual exam is a once-a-year visit to your Gynecologist for a general health check, including a physical exam with pelvic exam. Annual exams are also called routine check-up, yearly exam, and annual paps.
What should I expect during my annual exam?
· General physical exam including breast exam and pelvic exam (pap smear when needed)
· Update of life and work situation
· Update of family health history (any new serious illnesses in your family?)
· Review of your health history
· Update of current medications, herbs, and supplements (bring list)
· Medication refills for prescriptions written by Dr. Motyka
· Evaluation of need for health screening tests based on age and personal and family history (such as mammogram, test for sexually transmitted diseases, and colon cancer screening) and ordering of these tests
· Update on immunizations
Please schedule a separate appointment if you have health concerns other than your routine physical exam and want to use you health insurance to pay. Examples are:
· A list of concerns or questions.
· New health care concerns or problems found at the time of your annual exam.
· Ongoing health problems that need more attention.
What happens if you have a new health problem when you come for your annual exam?
· You and your provider will need to decide whether to use the time that day to address your problem, in which case your annual exam visit can be rescheduled. Or you may choose to defer the health concern to another visit. Scheduled appointment times generally do not allow for both. Sometimes new problems or reviews of chronic conditions can occur during an annual exam but you may be charged a copay or coinsurance for evaluation and management of new or chronic conditions, especially if they fall out of the category of gynecology (we generally include time to discuss routine contraception, menopause care, STD testing, cycle regulation, and fertility).
QUESTIONS ABOUT YOUR BILL
What billing or insurance information will I receive?
You will receive a copy of your bill. After your insurance has paid, we'll provide you with a monthly statement of your account.
How long will it take to get things settled with the insurance company?
Generally, it takes from 45 to 60 days to obtain payment from an insurance carrier.
Why am I getting bills from physicians?
Each physician who provides professional services will send you a separate bill from his or her office. These physicians will include:
- your own physician
- other physicians who conducted tests and procedures
- consulting physicians chosen by your primary physician to read and interpret test results.
These physicians may include specialists in anesthesiology, cardiology, emergency medicine, nuclear medicine, pathology, radiology, or urodynamics. You will be responsible for paying these bills as well.
I received a notice that my insurance company has paid on my bill -- but I can't understand how they calculated their payment amount. Do you know?
If we have received any such information from your insurance company, we'll be glad to share it with you. However, for answers to any questions about insurance payments, deductibles, or co-payments, you generally need to check with your insurance company.
If you need health insurance and it is not available through your employer visit https://www.healthcare.gov/
Although we are not in network with Medicare or Medicaid, we will be happy see patients with these plans as cash pay with a discount. Labs and medications, and radiology testing will be covered by insurance. The visit will not be covered. If you have a secondary insurance we can submit that for you so you can be reimbursed.
If you need info about NC Medicaid check out
this site explains the choices
Apply online at ePass.
Apply in person at your county Division of Social Services (DSS) office. It helps to fill out as much of the application as possible ahead of time.
Call your county DSS office if one of these methods will not work for you.