The Hirsch Pediatrics FAQ's and Policies...

Billing and Insurance

• Are there additional fees including those for school/camp forms, after-hours phone calls, prescription refills, or copies of my child's records?
• How do you manage insurance and billing?
  
  

Are there additional fees including those for school/camp forms, after-hours phone calls, prescription refills, or copies of my child’s records?

No.  There are no additional fees for other standard services such as completing school/camp forms, after-hours phone calls, prescription refills, or copies of your child's records if requested by a parent or other medical office. 

There will, however, be a fee for copies of your child's records if the request is from an outside agency, organization, or law firm, as well as for an excessive amount of records requested by a parent. In these instances, the guidelines and fees for copying the records are dictated by Maryland law and the federal HIPAA act of 1996, not by Hirsch Pediatrics. Please call the office for additional details.

How do you manage insurance and billing?

In-network care

We participate with the following insurances listed below. We also participate with several smaller insurance plans that are not listed below.  Please call our office if your insurance is not listed under the in- or out-of-network section.

Adventist Health
Aetna
Beech Street PPO
BlueCross BlueShield
CareFirst
Cigna
Coventry
Great West
Johns Hopkins Healthcare
NCPPO
PHCS
Tricare Standard PPO
Unicare

Note:  If your insurance plan requires you to designate a primary care physician ("PCP"), you must select our office prior to your first visit. If Dr. Hirsch is not designated as the PCP prior to the first visit, you may incur extra costs if the insurance company requires us to process the claim as an out-of-network visit.

Out-of-network care

We also welcome families who wish to be part of the Hirsch Pediatrics family and are self-pay or will utilize their out-of-network benefits. Despite having in-network benefits at other offices, many families prefer to use their out-of-network benefits at Hirsch Pediatrics to enjoy the patient centered, family like atmosphere of our unique solo practice.

The following insurances will utilize their out-of-network benefits for care at Hirsch Pediatrics.

Alliance
MAMSI
MDIPA
OneNet PPO
Optimum Choice
United HealthCare

In using your out-of-network benefits, we will collect the entire appointment charge from you at the end of the appointment. As of April 1, 2010, Hirsch Pediatrics is no longer able to submit the out-of-network claim directly to your insurance carrier. However, after the appointment we will provide you with the necessary documentation that will allow you to easily submit the claim to your insurance company for reimbursement.

The amount of reimbursement depends on your out-of-network benefits. Please note that in some instances the appointment costs will be the same or only slightly greater than the cost you would have incurred by paying your co-pay with an in-network provider. This is especially true for plans that have above average out-of-network benefits and for plans that involve a Flexible Spending Account (FSA) or Health Savings Account (HSA).

If you would like more detailed information on the expected out-of-network costs for your family, please call or e-mail our office.