Payers

Issue with UnitedHealthcare

We are experiencing an issue with UnitedHealthcare (UHC) policies sponsored by Delta Airlines. The issue is well check visits are currently not being covered, because UHC states the visit was provided by an out-of-network provider. Vibrant Kids Pediatrics is an UnitedHealthcare in-network provider, and only polices issued by Delta Airlines are having this issue—all non-Delta Airlines UHC …

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Again Accepting BCBS

Effective April 14, 2017 we are again able to accept BlueCross BlueShield policies as payment for services rendered. We have received word from our provider network representative that Dr Jill has been restored in BlueCross BlueShield of Georgia (BCBSGa) systems, and claims should again process correctly effective April 14th. It will still be a lengthy …

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Unable to Accept BCBS

Effective April 13, 2017 we can no longer accept BlueCross BlueShield policies as payment for services rendered. For reasons yet to be explained by BlueCross BlueShield of Georgia (BCBSGa), BCBSGa apparently terminated our contract effective March 2, 2017. We became aware of this on March 23, 2017 when the first claim denials for dates-of-service on …

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No Longer Accepting Medicaid or Medicaid CMOs

It is not a WellCare of Georgia mistake this time. Effective January 1, 2016 Vibrant Kids Pediatrics will no longer accept Medicaid (including PeachCare for Kids) or any Medicaid CMO—e.g. Amerigroup, Peachstate or WellCare of Georgia. We will not accept these payers as either a primary or secondary payer. As a small business we can no …

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Additional Letter from WellCare

Have you recently received a—for some a second—letter from WellCare of Georgia informing you that Dr Dickerson is no longer in-network? WellCare of Georgia—in response to Piedmont Clinic’s request to remove Dr Dickerson from its roster of WellCare of Georgia providers—has terminated Dr Dickerson’s Vibrant Kids Pediatrics provider ID, rather than her Piedmont Clinic provider ID. This mistake is what …

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Letter from WellCare

Have you recently received a letter from WellCare of Georgia informing you that Dr Dickerson is no longer in-network? This letter was sent to you because your WellCare of Georgia primary care physician (PCP) is Dr Jill Dickerson at Piedmont Clinic. Only recently has Piedmont Clinic updated WellCare of Georgia that Dr Dickerson is no …

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Are you accepting “exchange” plans?

We are currently accepting Health Insurance Marketplace plans—as we have not yet been notified of any significant reimbursement reductions with our contracted payers that are providing such plans. We are monitoring our experience with these plans very closely, and we reserve the right to stop accepting these plans should we encounter any reimbursement delays or reductions. Your …

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What do you mean by “third-party payer”?

“When you say ‘third-party payer’ are you referring to my ‘health insurance provider’?” Yes. Words mean things, and we believe in defining things by using the correct words. In today’s healthcare economy, the majority cost of your healthcare is paid for by someone else—a third-party—who either is your employer or are your neighbors (via taxpayer dollars). Today’s “health insurance” is not insurance …

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