Fees and Insurance
Fees are payable at the time of your office visit unless other arrangements are made in advance of your examination. All copays, deductible and/or co- insurances are collected at the time of service. We accept all major credit cards and personal checks for office visits.
Please be advised that some telephone consultation calls for medical management issues after business hours or during business hours may be billed for a service fee.
Effective June 1, 2014: All appointments not cancelled within a 24 hour notice are subject to a $75 fee.
Our office does not participate with Medicare. We do, however, participate in several managed care plans and preferred provider plans. If you are a beneficiary or a member of a plan we do not participate with, your paid receipt will provide you with a detailed statement of services, charges and diagnosis so that you may file a claim with your carrier for personal reimbursement.
If you require surgery, our surgery coordinator will give you a call to discuss your insurance coverage in advance of your procedure. A deposit may be required prior to your procedure. As a patient receiving services in our care and regardless of your health insurance plan coverage, you are fully responsible for all non-covered services, copay’s and deductibles.
Our trained staff members are available to answer any questions you may have regarding your insurance coverage or our fee schedule. Please do not hesitate to discuss your concerns with us.
Please contact our Business Office representatives prior to any office procedure or outpatient surgery to review your financial obligation and insurance coverage at 888.318.2788.
Accepted Insurance Plans
For your convenience, we have provided links to the Insurance companies for which we participate with so you can easily check your benefits and claim status. Please call us so we can discuss your particular insurance concerns. You can reach the billing department by telephone at 888-318-2788. Thank you!
Accepted – Health Insurance Plans
AETNA- PPO, POS, CHOICE POS II
AETNA OPEN ACCESS
BLUE CROSS BLUE SHIELD – PPO
- (BCBS Blue Options Tier 2 Only – Following acronyms may display bottom left of card: BCE, BCO, CTY, EPO)
CIGNA- PPO, POS, HMO
COVENTRY- PPO (Tier 2 plans only)
- First Health Network & State of IL OAP
- FIRST HEALTH- PPO
GREAT WEST- PPO, POS
HUMANA- PPO, POS
PHCS – PPO, POS
PHCS SAVILITY- PPO
UMR/FIRST HEALH – PPO
UNITED HEALTHCARE- PPO, HMO
Due to the changes implemented and imposed by insurance companies, Northwestern Memorial Hospital, Northwestern Lake Forest Hospital and its physicians will not be available to individuals who are required to purchase their health care on the ACA exchange. The Women’s Group of Northwestern is not in network with the following insurance products:
INSURANCES – DO NOT ACCEPT
Aetna Open Access
– Metallic options- Platinum/Gold/Silver/Bronze
Aetna SAVINGS PLUS – Aetna Value Performance Network
Blue Cross Blue Shield Blue Choice Preferred – PPO, POS, HMO
Cigna Connect HMO
Coventry- State of Illinois HMO,
Coventry Health Care – HMO/POS, PPO, Advantra HMO, PPO qualified high deductible
Coventry One – PPO, Select, Exchange
United Healthcare – Core, Navigate, Compass
Please feel free to contact our business office for assistance and recommendations with respect to your insurance selections. We apologize for any inconvenience. Our toll free number to the billing office is 888-318-2788.
Introducing our new Navicure E statements
Paying Your Medical Bills Just Got Easier. Our practice has implemented e-statements. This will allow you to receive a secure electronic statement, via email or text. You will be able to pay your outstanding balance or bills via private, secure communication. Please indicate your preference at the time of your next visit.
Take advantage of this opportunity to help our environment “GO GREEN”.
UNITED HEALTH CARE
Attention United Healthcare Members, Effective April 15th, 2014, All our providers participate and will be in network with United Healthcare PPO & POS. Please we are NOT in network for United Healthcare Core.
Ultrasounds for United Health Care Patients:
We are pleased to announce Ultrasound services for United Health care patients. You can now schedule your next ultrasound appointment at our office.
Please ask one of our staff to schedule your next appointment.
Insurance and Your Obstetrical Care
We are happy to assist you in any way that we can in billing our charges for your obstetrical care and delivery to your insurance carrier. You must realize that you need to be aware of your own insurance benefits as not all carrier coverage are the same. Our Obstetrical Coordinator will meet with you early in your pregnancy to explain the charges and global billing.
If we provide your complete care and delivery, we will be charging a “global obstetrical fee” after delivery. This fee includes your 14 routine visits to the doctor during your pregnancy, our charges for delivery of the baby, and your routine postpartum visit. Any additional visits beyond 14 visits will be billed to your insurance company and are your responsiblility. The hospital and anesthesiologist will bill their charges separately to you and/or your insurance carrier. Any other services we provide, including ultrasounds, lab tests, non-stress tests, amniocentesis, etc are outside of the global fee and are charged separately. If you change insurance carriers or providers of medical care during your pregnancy, we will have to bill by itemized service performed, rather than a global fee.
Ultrasounds that are billable to your insurance company are done for medical necessity, not for determining the gender of your baby, or for entertainment purposes. As always, please feel free to clarify any questions and concerns you may have by contacting Nikki W at 312.291.7287 and/or any billing representative at 888.318.2788.
Click Here to Download the Billing Policy/Maternity Insurance Form
What is “global billing?”
Global billing is most common in obstetrical (OB) care, but can also apply to other non-OB services. It is a billing method used by most insurance companies which includes office visits related to pregnancy, physician’s charge for delivery and one six week postpartum visit. The “Global Charge” is billed to your insurance by our office at the time of delivery and the hospital will bill separately. Anything above and beyond your antepartum visits and delivery including, but not limited to ultrasounds, blood draws, sick visits, lab and pathology services, fetal non-stress tests, amniocentesis, etc will be billed outside of global and deductibles and/or co-ins may apply.
Global billing applies to all pregnancies when you have the same insurance throughout the entire pregnancy and when you see only WGNW providers throughout the entire pregnancy. If you have changes in insurance coverage or if you transfer care to or from our office, global billing no longer applies.
What is an “OB Deposit?”
All patients with verified COMMERCIAL insurance are required to pay a deposit based on insurance benefits. The deposit is due in full or in four monthly installments. The first payment is required at your initial visit. The final installment is due by the first day of your seventh month. After you deliver, the office will bill your insurance for the physician’s delivery charge and global fee. Whatever amount your insurance does not pay, we will use your deposit to pay off your account and then refund any necessary balance.
All patients that are SELF PAY are required to pay the cost in full prior to your delivery. This can be broken down into four installments or paid in full. During your initial Obstetrical visit, you will meet with our Obstetrical Coordinator to set up a payment plan. Payment is required in full by the 25th week of pregnancy or four monthly installments automatically deducted from your Preferred Credit Card on file.