The Pediatric Cardiology
Medical Group –East
Bay has contracts with most private and public insurers and medical
groups in the area. Children’s Hospital and Research Center
at Oakland is a separate entity which also has contracts with most
private and public insurers and medical groups in the area. When
you see the cardiologist, the statement will be sent to your insurance
company for the cardiologist’s services. If the cardiologist
orders a test or your child has a procedure at Children’s Hospital,
the Hospital and the Cardiologist will send a statement to your insurance company.
The fact that two entities are involved in your child’s care
can be confusing. If you have questions about your coverage or any
bills that you receive you are encouraged to call the cardiology
department for clarification. In some instances it may be necessary
for you to contact your employer or the insurance company for clarification.
If you do not have insurance and want to discuss
the financial impact of your child’s heart condition, you should contact
the department’s social worker. Payment arrangements can
be negotiated for both physician and hospital services.
Private Insurance
It is strongly recommended that you contact your insurance company
before your child’s visit with the cardiologist to confirm
that the cardiologist and Children’s Hospital and Research
Center at Oakland are members of your network. Likewise, you
should confirm any authorizations or referral requirements. Taking
these steps before you child’s appointment will help avoid
any confusion or undue financial penalty on or after the visit.
Our office staff will assist you in getting any necessary authorization
or referrals. Please make sure you bring your insurance card to
all office visits. You should also be prepared to pay any co-payment
required by your insurance company at the time of the visit.
MediCal
If your child has MediCal, please make sure that you bring the
valid MediCal stickers with you each time your child has an appointment.
If you have not received your MediCal card, please call the cardiology
office before your visit. If your child’s MediCal case
is pending, please contact MediCal and let them know of your
child’s need to see a cardiologist and your need to have
the MediCal stickers.
CCS
California Children’s Services (CCS) is a State of California
program designed to assist income eligible families with eligible
medical bills. Most cardiac conditions qualify for CCS coverage.
If your child has MediCal, you will be automatically referred to
CCS. If you have private insurance, you may still be eligible for
assistance through the CCS program. Our office will provide you
with an information sheet that more fully explains the CCS program.
Please note that the Pediatric Cardiac Center at Children’s
Hospital and Research Center at Oakland is a CCS approved tertiary
care center.
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