Financial Policies
Financial Information
Thank you for choosing Hilliard Pediatrics. We are commited to providing your children with the best care possible and believe in healthy communication with our families; therefore, the following information is provided to help avoid any misunderstanding or disagreement concerning financial responsibilities for services provided in our office. We attempt to be as transparant as possible, but can't cover every scenario that may occur. Our staff are always happy to answer any questions you may have at any time.
Hilliard Pediatrics is in network with most commercial insurance companies. However, new plans are created all the time and it is impossible for us to know what each individual insurance policy will or will not cover. For example, some Freedom Life plans pay for preventive “well” visits while some cover only a portion of the visit, and others none at all. Some policies require a co-payment and/or co-insurance, while others do not. We do our best to stay up to date when new plans become available, but please always check with our insurance company to make sure Hilliard Pediatrics (some list the individual providers rather than the practice) is in network.
If we do not participate with your insurance company, we will be happy to see your child “out of network.” This may mean a reduction in your benefits. Since every insurance company has different rules, it is impossible for our staff to know what your insurance will pay. Please check with your insurance company or your human resource department.
If you do not have insurance (i.e. you are self-pay) all charges are to be paid for on the visit date. A prompt payment discount may be applied if payment in full is made on the date of service.
Commercial Insurance
Commercial health insurance, often called group health insurance, is the most common form of health insurance in the United States. is a type of insurance that is sold and administered by a private compnay rather than provided by the government. This includes insurance through your employer and individual plans you may purchase. The major commercial insurance carriers that we accept are:
- Aetna (including Allied Benefits and Meritain Health)
- Anthem (BlueCross/Blue Shield)
- Cigna
- Medical Mutual of Ohio
- OhioHealthy
- OSU Health Plan (Luminare)
- UnitedHealthcare (including All Savers, Freedom Life, Golden Rule, Surest, and UMR)
Health Insurance Marketplace (ACA) Plans
The Affordable Care Act (ACA) requires that every state has an exchange where consumers can buy individual health insurance policies. In Ohio, the federal government runs the health insurance exchange. Hilliard Pediatrics is in network with the following plans from the Ohio's 2024 Health Insurance Marketplace:
- Anthem Blue Cross and Blue Shield (Bronze, Silver and Gold Pathway X Plans)
- MedMutual Market
- UnitedHealthcare
*** Please note we are NOT in network with the following plans from the Marketplace: Aetna CVS Health, Ambetter from Buckeye Health, CareSource Marketplace, Molina, and Oscar. We are aware that CareSource still lists our providers as in network, but we do not have a contract with them. We have been in communication with them multiple times in an attempt to get this resolved. ***
Tricare
We are considered non-network providers for Tricare. Our region is covered by Humana Military. Based on the Tricare website, here is the relevant information about seeing a non-network provider:
- You'll see non-network providers when using TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult-Select or if enrolled in TRICARE Prime Remote and there are no network providers available in your remote location.
- If enrolled in TRICARE Prime, you may see a non-network provider only if:
- You decide to use the point-of-service option, or
- It's approved by your regional contractor because no other providers are available.
Medicaid/Medicare
Hilliard Pediatrics is NOT in network with any form of Medicare or Medicaid. This includes BCMH. That means that we are unable to bill any form of Medicaid in our office.
At Hilliard Pediatrics, we are committed to providing your children with the highest quality care at a fair and reasonable cost. As a part of your relationship with Hilliard Pediatrics, please read the financial policy below to get yourself a handle on your financial obligations. These policies protect our ability to successfully provide care and responsibly adhere to mandated guidelines established by patient selected and contracted insurance companies. Your familiarity with the following policy statements and your willingness to comply are imperative for the delivery of our pediatric care. We have in-house specialists who are trained to answer any of your questions pertaining to your financial obligations and insurance issues. If you have questions about your insurance coverage, please call your insurance company.
Hilliard Pediatrics believes it is important for families to know about the cost of their care. We are committed to making sure patients have access to information on out-of-pocket costs or what insurance does not cover. Our billing team is available to help answer any questions and assist families in making informed decisions about the cost of their care.
- To the best of our knowledge and belief, Hilliard Pediatrics has included all applicable standard charge information and that the information encoded is true, accurate, and complete as of the date indicated in the file.
- The list of standard charges is not an estimate of your out-of-pocket costs for services at Hilliard Pediatrics.
- Your out-of-pocket costs depend on the actual services that you receive. Costs also depend on Hilliard Pediatrics’ negotiated rates with your insurance plan, and your insurance coverage.
- Your insurance determines your co-payment, co-insurance percentage, and annual deductible.
- The actual services and supplies that you receive for your care may vary. It can be different from what was in your initial care plan. You may also get services from doctors, other care providers, or laboratory service companies who are not employed or operated by Hilliard Pediatrics. The standard charge and the health plan negotiated charge for these outside providers are not reflected in the fee schedule.
- Nationwide Children's Hospital (NCH) provides outside laboratory services for Hilliard Pediatrics. Any labs that are sent out of this office for processing are sent to NCH unless you specify otherwise at the time of service. To access pricing for these services, please visit NCH's price information list here.
We are here to help you understand the cost of your care. Please contact our billing staff at (614) 777-1800, opt. 5 for additional pricing and billing information related to your claim.