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APM Spine & Sports Physicians

BILLING AND INSURANCE INFORMATION

Billing/Insurance – Information and Procedures

Q: Do I have to pay my co–pay in order to be seen?
A: Co-insurance and deductibles are expected at the time of the visit.

Q: What insurance does APM accept?

A: As of November 1, 2016:

  • APM accepts the following insurance:

• OPTIMA
• Blue Cross/Blue Shield
• Medicare
• Virginia Medicaid
• Tricare
• Cigna
• Aetna
• United Healthcare
• Most Commercial Insurances

  • Insurances that Require a Referral:

• Healthkeepers (POS and HMO)
• Humana HMO

  • Worker’s Comp Guidelines:

• Case manager or adjuster must call and schedule the first appointment
• The following information must be provided
• Date of injury
• State of injury
• Body part injured
• Case manager or adjuster’s name and number
• Insurance name, number, address and adjuster

Plans which we DO NOT accept:

• Healthkeeps Plus
• Optima Family Care
• Optimum Choice
• Virginia Premier
• MAMSI
• Alliance

Q: If I have no health insurance coverage, what is the cost of my treatment?
A: The costs vary depending on what type of treatment is needed. We will try to work with you to help you obtain the care you need.

Q: What is the cost for the office visits and procedures?
A: Please contact the office for all pricing information.

Q: What are the billing procedures and payment options for my treatment?
A: Billing procedures are simplified by sending bills after an insurance statement and payment are received. This helps to ensure correct billing. Our Billing Office can answer any questions about your bills or to help with your questions about insurance forms. Our office accepts cash, personal checks as well as VISA, MasterCard, and Discover cards.

Q:  What is a deductible?
A:  This is an amount you are responsible for based on the type of coverage you have selected with your insurance company.

Q:  What is the difference between my co-pay and coinsurance?
A:  A co-pay is the amount designated by your carrier that identifies a set amount for the office visit. Typically there is one for your primary care provider and a different amount due a specialty provider.
Co-insurance is a percentage due, determined by your benefit plan and the contract with your carrier and your provider.
 
Q:  How is my cost share determined for my Health Savings Account (HSA, HIA and HRA plans)?
A:  Health Savings, Health Incentive and/or Health Reimbursement plans are typically high deductible plans (i.e. $3,000-$6,000) where patients, families must pay the full insurance allowance for the services rendered. Once these high deductibles are met their benefits under a PPO reimbursement would activate.
 
Q:  When will I receive a refund?
A:   Overpayment refunds will be:

• Processed and mailed within 30 days or;
• Applied to open balances.

If you have any questions, please contact APM Spine and Sports Billing Office @ 757-668-8613

Q:  When and how often will I receive a billing statement?
A:  Monthly statements will be mailed to the guarantor’s home address provided at the time your child was registered at his/her appointment.
 
Q: What if I have any questions about my bill?
A: All questions related to your bill should be addressed our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613, Monday through Friday, between 9:00 a.m. and 5:00 p.m.
 
Q:  Who do I contact if I have not received a billing statement?
A:  You may call our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613
 
Q:  How do I update my insurance information if it has changed?
A:  Contact Children’s Specialty Group’s Central Business Office with insurance updates.  To contact CSG’s customer service department, you may:

• Call our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613.    
• Use our Patient Portal. You can sign up by clicking the link at the bottom of our website.

Q:  When and how often will I receive a billing statement?
A:  Monthly statements will be mailed to the guarantor’s home address provided at the time your child was registered at his/her appointment.
 
Q: What if I have any questions about my bill?
A: All questions related to your bill should be addressed our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613, Monday through Friday, between 9:00 a.m. and 5:00 p.m.
 
Q:  Who do I contact if I have not received a billing statement?
A:  You may call our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613
 
Q:  How do I update my insurance information if it has changed?
A:  Contact Children’s Specialty Group’s Central Business Office with insurance updates.  To contact CSG’s customer service department, you may:

• Call our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-8613.    
• Use our Patient Portal. You can sign up by clicking the link at the bottom of our website.