Pediatric Health Care's Insurance Information

Pediatric Health Care participates with several insurance companies for the convenience of our patients. It is your responsibility to be aware of your insurance benefits. Each contract has varied benefits, deductibles, co-pays, and maximums. 

We strongly urge you to contact each insurance company directly to confirm our office's status within their network before changing or purchasing any coverage. Our physicians may appear in-network at addresses associated with Beaumont Health System (Royal Oak & Troy); this is due to their admitting privileges at these locations. Please have the insurance company representative confirm our provider's information for our Sterling Heights office location (which is our only office location); providing the representative with our group NPI: 1962446567 may expedite their search process.

Our billing department will be diligent in filing your claim, however, any dispute in coverage is between you and your insurance company claim. It is your responsibility to cover services that your insurance company does not. Payment is due at the time of services rendered.

If you have a billing question, you may reach our billing manager in our office by pressing #3 on our phone prompt or email from our "Contact Us" page, under "Billing".

Pediatric Health Care participating insurances:

 
  • Beaumont Employee Health Plan/UMR  
 
  • Blue Cross Blue Shield: (Employer): PPO: My Blue, Community, Preferred Plus | Auto Industry & Federal Plans | Out of State  
 
  • Blue Cross Blue Shield: (Marketplace)*: Preferred HMO, Select HMO, Multi-State, Premiere  *EXCLUDES Metro Detroit HMO Network 
 
 
 
 
  • HAP: PPO, HMO, POS, EPA, EPO, Preferred  hap *Open Delivery System Network
 
  • Medicaid Products: Straight, McLaren, Meridian medicaid
 
  • McLaren: PPO, HMO (private insurance) mclaren
 
  • Priority Health: Priority: HMO, PPO, EPO | MyPriority: HMO, HMO Gold Network, PPO | Priority POS: A & B  priority
 
  • Cofinity/First Health Networks (www.cofinity.net)
 
 
 
 
   

Helpful Information:

  • Always bring your insurance card to each visit.
  • Copay is due at the time of visit. We accept cash, checks, debit and Visa/MasterCard. Failure to pay at time of service may result in a $7.50 service fee.
  • Some insurances require naming of a Primary Care Provider. Be sure that your have one of our physicians listed before your first visit to our office.
  • Upon the birth of a child, call your Human Resources to inform them of the new addition to your policy.
  • Always retain your receipts and explanation of benefits provided by your insurance company.
  • Be aware of your laboratory benefits. If your insurance company does not cover labs run in our office, please let us know.
  • If a claim is rejected, call your insurance company first. Most questions regarding non-payment of a claim can be answered by them. It is not our responsibility to mediate a dispute between you and your insurance carrier.
42141 Mound Road  -  Sterling Heights, MI 48314  -  phone: 586-254-7593  -  fax: 586-254-7834