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Insurance

We recommend contacting your health insurance provider to obtain the most updated network participation status, as online lookup tools are not always accurate. It is important for you to understand your insurance benefit details for wellness and sickness visits, as having insurance does not mean that all visits will be covered at 100%.

We accept most plans from the following insurances:​

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  • Aetna

  • Aetna Marketplace

  • Allied

  • Allsavers

  • Anthem 

  • Blue Cross Blue Shield

  • Blue Cross Blue Shield Marketplace

  • Cigna

  • Cigna Marketplace

  • Healthsmart

  • Netwell

  • Meritain Health

  • Multiplan

  • PHCS

  • Premera Blue Cross Blue Shield

  • Superior Health Plan

  • Surest

  • Trustmark

  • UMR

  • United Healthcare

  • United Healthcare Marketplace

  • US Health Group

We DO NOT accept:​

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  • Ambetter Value Plan

  • Baylor Scott and White Health Plan (Dr. Singh is in network, but the facility is not)

  • Blue Cross Blue Shield - Blue Choice Preferred

  • Bright Healthcare

  • ​The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

  • Cook Children's

  • Friday Insurance 

  • Medicaid

  • Molina Medicaid or CHIP

  • Oscar Insurance

  • Parkland

  • Tri-care

  • TMHP Medicaid

  • United Healthcare Texas Star

  • United Healthcare Charter

  • Wellpoint/Amerigroup Medicaid or CHIP

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At this time, we are not accepting any New Patients with Medicaid, CHIP, or cash pay.

Understanding Your Insurance Benefits

Our staff will do their best to help you navigate your insurance benefits. However, it’s strongly recommended that you contact your insurance provider directly to fully understand your plan, as benefits can vary widely. You can find the Member Services phone number on the back of your insurance card.

Before each appointment, we verify your insurance eligibility and benefits. Claims are submitted and processed before any balances are billed to you.

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When speaking to your insurance provider, ask about coverage for: 

  • annual physical exams

  • time required between wellness visits (renewal every 365 days or at the start of every calendar year) 

  • routine immunizations 

  • sick visits to a primary care office​

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Annual Wellness Visits (Well Child Checks):
Most insurance plans cover one wellness visit/routine physical per year. Some require at least 365 days between visits, while others allow one per calendar year.

These visits typically include: 

  • vision and hearing screenings 

  • developmenal and vital sign assessments 

  • physical and spine exam 

  • orders for routine bloodwork

Important: If your child is sick during a wellness visit or non-preventive issues are addressed, an additional charge may apply. This could be subject to a copay, coinsurance, or deductible.

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Insurance Terms to Know: 

  • Deductible: The amount you pay out-of-pocket before your insurance begins covering services.

  • Coinsurance: The percentage you pay after meeting your deductible.

  • Out-of-Pocket Maximum: The most you'll pay in a policy year; once reached, your insurance covers 100% of eligible services.

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Please Note:
While we are happy to assist, it is your responsibility to understand your insurance benefits. We are not your insurance provider and may not be able to answer all plan-specific questions. We kindly ask that you treat our staff with respect.

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Billing Questions?

Please contact our billing department:​

Top Resource Medical Billing 

Phone: 972-207-8401

Fax: 214-710-2156

mybill.trmb@gmail.com

Office Hours: Mon-Thurs 8:30am-4:30pm, Friday: 8:30am - 12:00pm

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HEALTH INSURANCE 101

Unraveling the mysteries of medical insurance, so you can focus on your child’s health and well being.

5501 Independence Pkwy, Suite 300

Plano, TX 75023

Phone: 972-867-8979

Fax: 972-758-0871

OFFICE HOURS

Monday - Friday: 9 am - 5 pm

Saturday: 9am - 2pm
Sunday: CLOSED

©2023 by Carefirst Pediatrics.

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