Billing and insurance

Billing & Insurance Information

Billing Questions

You can make a secure payment online by visiting our QuickPay Portal. You will need your QuickPay code, statement ID, or access code. This can be found on your statement.

 

For billing questions, please contact us securely online by logging in to your Patient Portal account. Alternatively, you may call us at 813-948-8814 (Wesley Chapel) or 813-719-3716 (Plant City) and press option 3.


Accepted Insurance Plans

We are in-network with most commercial and Medicaid insurance carriers, including the below. However, this list may not be up-to-date, or these insurances may have complex restrictions for some of their plans. Therefore, it is important that you verify with your insurance that we are in-network for your specific plan. Otherwise, they may not cover the visit. In this case, you will receive a bill for services at our competitive self-pay rates.

  • Adventist Health System Employee Health Plan
  • Aetna
  • Aetna Better Health (includes Healthy Kids and Medicaid plans)
  • Avmed
  • Blue Cross Blue Shield (includes Florida Blue, but excludes Blue Select and myBlue plans)
  • Bright Health (starting January 1, 2020)
  • Cigna (excludes "BayCare Exclusive Network" plans)
  • Cofinity
  • First Health
  • Florida Hospital Care Advantage
  • Humana (includes Medicaid plans)
  • Multiplan
  • Oscar Health (starting January 1, 2020)
  • PHCS
  • TRICARE
  • UMR
  • UnitedHealthcare (includes Healthy Kids, but excludes Medicaid MMA plan)
  • Wellcare / Staywell (includes Healthy Kids and Medicaid plans)
  • We also offer competitive self-pay rates for individuals with no insurance.

Preventive Care & Hidden Copays

Your Preventive Care Visit (“physical” or “well visit”) includes a routine physical exam, immunizations and services such that have been defined by the Patient Protection and Affordable Care Act. For most private health plans, providers will not charge a copay, deductible or coinsurance for preventive services. Please be aware that if you have other health issues, check with your insurance company about what preventive services are covered by your plan.

 

Even if a preventive test or screen is fully paid by insurance, you may still receive a bill for a copay or co-insurance for the office visit. That is, the preventive care is free, but the doctor’s assessment is not.

  • The Preventive Care Visit, which includes a routine physical exam and immunizations does not require a copay.
  • If you discuss symptoms of acute problems or chronic diseases at the Preventative Care Visit, it is considered “diagnostic” and you will most likely be required to pay a copay.

Example: You make a doctor’s appointment specifically for a preventive service or test, but during the course of the visit you are treated for an unrelated problem, like allergies or changes in your ADD medication. For this visit you would be required to pay the copay for the office visit.

 

The decision of charging a copay for a visit is not decided by Dr. Bou Pediatrics; these decisions are based on federal laws and insurance regulations. Complaints of this nature should be directed to your insurance company. 

Newborns

For commercial insurance plans, you must contact your insurance carrier as soon as possible after your child is born to activate their coverage. This step is mandatory, as we are not allowed to bill the parent's insurance directly. Please be aware that most plans only allow for this step to be completed within 30 days of birth. Otherwise, they may not retroactively cover any visits. In this case, you will receive a bill for services at our competitive self-pay rates.

 

For Medicaid insurance plans, you must contact the Medicaid office at (877) 711-3662 to activate your newborn's coverage and designate Dr. Salvador A. Bou-Gauthier as the primary care provider (PCP). Alternatively, you can go online to flmedicaidmanagedcare.comYou must write down the confirmation number to provide to our office in order to schedule your first appointment.

Dr. Bou Pediatrics - Plant City, FL | Wesley Chapel, FL