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Insurances

NGPC

North Georgia Pain Clinic is committed to serving our patients with integrity and professionalism.  Our Financial and Front Office Staff will make every effort to assist our patients with questions as they may pertain to your insurance. However, it is the responsibility of our patients’ to ensure that you have checked and validated that your insurance is accepted by our office prior to time of your office visit.  Please check with your insurance and see if a pre-authorization or referral is needed for office visits as well as procedures.

If you are being referred outside of our practice, please allow 48-72 hours for us to process the request and get all of the insurance authorizations/referrals required. Please call before your scheduled appointment to ensure we have received your authorization from your primary care physician or insurance carrier. North Georgia Pain Clinic works hard to create lasting relationships with medical insurance companies, also known as “Managed Care Payers”, to ensure you’re receiving the best possible care at the best possible price. We accept most Commercial Insurance and Medicare plans.  PLEASE CALL OUR OFFICE AND VERIFY WE ARE ON YOUR “PLAN”.

Medicare Part B patients pay 20% of Medicare-approved services, after the deductible is met.

Accepted Insurance Carriers and Plans

    • Aetna Medicare Advantage
    • Ambetter Health Gold, Silver and Bronze Core Plans Only; Balanced and Core Plans (we do not accept Wellstar, Piedmont Network, St. Joseph Candler Select, Virtual Access, Essential Care, Select, Select Plus plans or Everyday Gold)
    • Anthem BCBS Commercial Blue Choice, Blue or Open Access, PPO, POS, HMO/Open Access (select plans)
    • Anthem Medicare Advantage State plan/SHBP, (we do not accept Pathways HMO)
    • Assurant Health
    • CIGNA Healthcare Commercial HMO, POS, PPO, Open Access Plus (we do not accept Local Plus, Cigna Connect, Cigna HealthSpring)
    • Humana Commercial PFFS/PPO/HMO (we do not accept HMOx)
    • Humana Medicare Advantage Plans PPO, POS, PFFS, Medicare Plans
    • Humana Military (TRICARE South Region)
    • KPIC Kaiser Permanente PPO/POS (non-par for DualChoice PPO)
    • Mail Handlers
    • Medicare & Medicare Railroad
    • New Era (Medicare Supplement)
    • NovaNet (through PHCS Network)
    • One Health Plan (through PHCS Network)
    • Pyramid Life Medicare (Medicare Supplement/MediGap)
    • Secure Horizons (Medicare Advantage)
    • Tricare for Life (Medicare-out of network benefits)
    • UnitedHealthcare Options (UMR)
    • UnitedHealthcare (UHC) Commercial HMO, PPO, POS
    • UnitedHealthcare Medicare Advantage AARP, UHC ChoicePlus, UHC Medicare Solutions
    • Workers Comp (Referral from designated physician or Adjuster) NOT NYC or USDL

We participate in the following Networks:

PHCS, MultiPlan, First Health Plan through Three Rivers

Note: These policies are subject to change based on our annual contract.  Please call our office at 770-479-2322, for the most up-to-date list of insurance accepted.

**Presently we do not accept Aetna CVS Health, MediBlue, Silver Pathway X HMO, Wellcare, Kaiser/PHCS-KA GA, Georgia Health Medicare Advantage, Sonder Health and Cigna HealthSpring.

 

Copyright © 2015 North Georgia Pain Clinic
Legal Disclaimer — the information contained on North Georgia Pain Clinic's website is not intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between North Georgia Pain Clinic and its practitioners may be created through the use of North Georgia Pain Clinic's website. Any individual with specific questions regarding his/her individual health or treatment options should contact North Georgia Pain Clinic to determine if an appointment with one of its practitioners would be appropriate or in the event of an emergency, dial 911.