What to Expect in 2019

In this issue:

  • Carmel Pediatrics Structural Change and What it Means to You
  • Insurance Marketplace Open Enrollment and Accepted Plans
  • Office Holiday Hours
  • Flu Shots

Carmel Pediatrics Structural Change and What it Means to You

For 31 years, we have billed each of our doctors under their own, separate Tax ID Number (TIN). While this structure is not wrong, this has certainly created some challenges for us over the years. Another way to look at it is each doctor had their own business within Carmel Pediatrics. So, say for example that you saw two different doctors for sick visits, and you ended up having a balance with each. You would have to pay each doctor in two different transactions. You would receive two different statements. Obviously, for you, this can be cumbersome and confusing at times.

Beginning January 1, 2019, we will begin to bill all five of our doctors under one, single TIN. Basically, we have combined all of the doctors under the Carmel Pediatrics, LLC umbrella. This will make the lives much easier for the billing team. However, what does this mean for you and how does it affect you? Here are a few items that you will need to know:

  • We have spent the last six months re-credentialing with insurance companies (which has been oh-so-much-fun). While we are not anticipating any problems with claims billed in 2019, there are always bumps in the road whenever a major change is made. We are asking you to be patient with us if any problems do arise. If there are any problems with any of your claims, we will be very transparent with you so you know what is going on. Our biggest fear are those smaller insurance companies. We are confident, however, that we have covered all of our bases.
  • You will receive one statement per month, regardless of which doctor you owe. When calling in payments, we will only have to run your credit card once. Our online bill pay system will change — you will not have to select a doctor to pay anymore. That’s pretty awesome.
  • If you are currently on a payment plan, we will be contacting you to set up a new payment plan, as the old payment plan will be null and void. We apologize for the inconvenience this may cause. Payment plans will be easier in the future, especially if you owe multiple doctors.
  • If you had set up accounts on the online bill pay system, those will be null and void as well. Your unique online bill pay code will also change. When paying any balances in 2019, just make sure you pay attention to that online bill pay code on your statement, and you should be fine.

If you have any general questions or about how this might affect you, please don’t hesitate to contact Nick Hannah, Director of Operations, at 317-582-7875.

Insurance Marketplace Open Enrollment and Accepted Plans

We have received a few questions lately about Ambetter insurance plans on the ACA Marketplace. None of our physicians are showing up in the 2019 list of doctors accepting Ambetter. This is not accurate. We believe this might be due to the new TIN change and credentialing process. We are currently working with our representative from Ambetter to get this fixed. Rest assured, we will be taking Ambetter in 2019, so if you have the insurance or are thinking about purchasing a policy through Ambetter, you are will continue to have a place in our family. We also accept Caresource on the Marketplace.

As a reminder, the final day of open enrollment for policies on the Marketplace is Saturday, December 15, 2018. Open enrollment for company based policies should be ending soon, too, so be sure to check with your HR team if you have any questions about your policy.

Holiday Office Hours

We will have slightly different hours during the holidays later this month. Please be advised there will be some days where we will only be here for half a day, seeing sick call only. So, if you have a sick child, please be sure to call first thing in the morning at 8:30 a.m. to ensure your child is seen that day. The schedule depends upon the doctor that is in that day, so be sure to call us before coming to the office if you need to pick up something. The phone recording will always be changed to let you know if we are closed early. If you need to reach a doctor after hours, the doctor’s phone numbers will be listed on the phone message. We typically close early on Christmas Eve and New Year’s Eve, but there may be others.

We will be CLOSED on December 25th and January 1st.