What insurance plans do CRH Physician Practices accept?

Aetna Medicare

Advantra Medicare

Amerigroup

Beech Street Corporation

Blue Cross/Blue Shield of Georgia PPO & Blue Open Access POS

Care Improvement Plus

Cigna Healthcare (Cigna PPO, Cigna Open Access Plus, Cigna State Health Benefit Plan Products, GWH-Cigna Network-formerly Great West)

CorVel Corporation Group Health Program/ CorVel Corporation Workers’ Compensation Program

Coventry (First Health PPO, Coventry HealthCare National Network, Coventry HealthCare of Georgia-HMO/Open Access/POS)

Coventry Workers’ Compensation Program·     

Evolutions Health Care Systems

Georgia Medicaid

Humana PPO and HMO (ChoiceCare Network PPO, Humana National POS – Open Access, HumanaOne)

IBG – Industry Buying Group

NovaNet Workers’ Compensation Program

Prime Health Services Medicare

Peach State Health Plan

PHCS – Private Health Care Systems

South Georgia Purchasing Alliance Inc.

SuperMed

Tricare/Champus PPO

TRPN – Three Rivers Provider Network

United Healthcare

Wellcare Medicaid

 

What is the difference between coinsurance and copays?
The terms "coinsurance" and "copays" apply to features in some health benefit plans that require the patient to share the costs of medical services with the insurance company. Typically, coinsurance is calculated as a percentage of charges for medical services. Coinsurance is commonly associated with inpatient hospital stays and major medical procedures. Copays are fixed amounts paid by the patient, regardless of the amount charged for medical services. Copays are commonly associated with physician office visits, prescription medications or some hospital services.

 

Can you bill me for my copay?
Copays are due/payable at the time of service, as we do not bill for them. Please be prepared to provide your insurance ID card and pay your copay when you come in for an appointment.

 

What is a deductible?
The deductible refers to the amount that you (the patient) must pay for medical services before your health insurance company pays claims on your behalf. This is usually an annual amount. Once you have "met your deductible," any medical claims subject to the deductible will be paid by the insurance company. Some services, like doctor visits, may not be subject to a deductible. Usually there are deductible amounts for each individual and for families.

 

Will my payment to CRH Physician Practices cover hospital fees also?
No. Hospital fees are billed by the hospital. For more information on hospital-related charges, please contact Coffee Regional Medical Center.

 

What services are covered by my insurance?
Patients often call to ask if a certain service is covered by their insurance. Unfortunately, we do not have ready access to the specifics of everyone's benefit plans.

 

We recommend you contact your insurance company directly. If you have employer-paid insurance, your human resources/benefits department is also a good resource. Sometimes a specific billing code is needed to get accurate information. We will be happy to help you with that information.

 

Can I use my spouse's insurance rather than my insurance?
If you have health insurance and are the subscriber, you must use it as your primary insurance coverage. The claims must be filed with your insurance carrier first. If you are also enrolled in your spouse's plan, it can be filed as secondary coverage, if there is a balance due after your insurance pays.

 

Insurance companies attempt to "coordinate" benefits between them. They share information in order to verify which carrier should be responsible for payment on behalf of a patient. If you are covered by two plans, you have likely received letters of inquiry asking you to verify your insurance plan(s).

 

Why were there charges not covered by my insurance company?
Your health benefits are determined by your specific benefits plan and the insurance company that provides them. They typically provide a list of services that are not covered (excluded) by your plan. If you receive a service that is not covered by your insurance plan, you will be required to pay. We recommend that you check with your insurance company to verify services that are covered.