Billing FAQs

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Listed below are some of the most Frequently Asked Questions (FAQs) related to billing.  Clicking the question will expand the box containing the corresponding answer.
Does Children’s Specialty Group participate with my Insurance Plan?

CSG Contracted Payers

  • Aetna HealthCare (PPO)
    • CCN
    • First Health
    • Coventry
    • Southern Health
  • Aetna Better Health of VA (VA Medicaid MCO/HMO)
    • Famis Aetna Better Health
    • VA Medicaid Products are now referred to as CardinalCare
  • Anthem BCBS, HK Inc., HK+, Famis HK+
    • VA Medicaid Products are now referred to as CardinalCare
  • Cigna Health Plan
  • Humana
    • Phased out > moved into VHN.
  • Magellan HealthCare – BH
  • Molina Complete Care of Virginia (VA Medicaid MCO/HMO)
    • Famis Molina
    • VA Medicaid Products are now referred to as CardinalCare
  • Medcost*
    • VHN
  • Medicare
  • NC Medicaid, NC Access, NCHC, Wellcare, AmeriHealth Caritas, Healthy Blue, and United Community of NC, Carolina Complete Health
    • BH – Trillium
  • Optima Health Plan, Optima Community, Famis Optima Community
    • BH – Separate Agreement
    • VA Medicaid Products are now referred to as CardinalCare
  • Tricare/Humana
    • BH – MHN (no longer, now that we are with Humana-Tricare)
    • Humana BH purchased the MHN agreement. MHN was assigned to Humana.
  • UHC*
    • MAMSI
    • MDIPA
    • Op Choice
  • United Behavioral Health – Optum Commercial
  • United Community/Famis United Community – (Virginia Medicaid MCO/HMO)
  • Virginia Medicaid, Famis FFS VA Medicaid, and Famis Select VA Medicaid (CardinalCare)
    • BH – VMAP Magellan
    • VA Medicaid Products are now referred to as CardinalCare
  • VPHP, Famis VPHP
    • July 1st, 2023 Virginia Premier Health Plan will be moving into Optima Community

*These are Payers are also Networks.  Be sure to look at the insurance card to confirm who to call for authorization and eligibility.  Typically Primary Network will appear on the front of the Insurance card, and if we are out of network, look for Secondary Network on the back of the card.

 

CSG Non-Contracted Payers

  • Multiplan* (Global Reimbursement Agreement).
    • Beech Street
    • BCE Emergis/UP & UP
    • Health EOS
    • PHCS
  • Beacon Behavioral Health
  • Cigna Behavioral Health Effective Oct. 18th, 2021

Out of State Medicaid and Out of State Medicaid MCO’s/HMO’s (Other than NC):

CSG does not participate with any other state Medicaid or any other out of state Medicaid MCO/HMO outside of VA and NC.

When and how often will I receive a billing statement?

An itemized statement is mailed out after services are rendered. You may opt to receive an “e-statement” via CSG’s patient portal.

Monthly statements will be mailed to the guarantor’s home address provided at the time your child was registered at his/her appointment.

Will I receive an itemized billing statement?

Yes, your first statement will be itemized. If the balance is not paid in full within 30-days of the first statement, your next statement(s) will show a “balance forward” amount only. Details are only provided on the first statement for each service date.

Who do I contact if I have not received a billing statement?
  • You may call our customer service line between the hours of 8:00 a.m. to 4:00 p.m. EST at 757-668-7200.
  • send us a direct email at CSG.BILLING@CHKD.ORG and/or;
  • you may complete an online Billing Inquiry Form.
What if I cannot pay in FULL?

If you are unable to pay in FULL or are experiencing financial difficulties you may contact our customer service team at 757-668-7200 and a mutually acceptable payment plan will be established.

How do I update my insurance information if it has changed?
Contact Children’s Specialty Group’s Central Business Office with insurance updates.  There are three methods 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 757-668-7200.
  • send us a direct email at CSG.BILLING@CHKD.ORG and/or;
  • you may complete an online Billing Inquiry Form.
What is a deductible?

This is an amount you are responsible for based on the type of coverage you have selected with your insurance company.

What is the difference between my co-pay and coinsurance?

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.

How is my cost share determined for my Health Savings Account (HSA, HIA and HRA plans)?

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.

When will I receive a refund?
  • Overpayment refunds will be processed and mailed within 30 days or;
  • Overpayments will be applied to open balances.
  • If you have any questions, please contact Children’s Specialty Group’s Central Business office.