Atlanta Women's Specialists takes great pride in its 40-year tradition of providing and advancing women's healthcare. As your Atlanta Ob/GYN, our physicians and staff are committed to excellence and innovation in medical care. As your obstetric and gynecologic healthcare needs change over time - from yearly checkups and contraception to pregnancies and, eventually, menopause - we're ready to serve you.
Insurance and Billing
Understanding how health insurance works is a challenge for most people. Our insurance department is staffed by personnel who'll help you. They'll do their best to explain the charges you incur as a patient and they'll work with you to get your claims paid.
For your convenience, we encourage you to use our website and your My Health Record account to handle billing-related issues. You can send a web message to one of our insurance representatives to request more details of a bill. You can also pay your bill via credit on our website.
Billing and Insurance Questions
What insurance does Atlanta Women's Specialists accept?
- Aetna Us Healthcare/Prudential
- BCE Emergis/UP & UP
- Blue Choice HMO, POS, PPO
- Blue Cross/ Blue Shield
- Choice Care Humana PPO
- Cigna PPO/HMO/POS
- Humana HMO, PPO, POS
- CCN (Community Care Network) First Health
- Oglethorpe University Student Health
- Lifewell
- Medicaid
- Wellcare (Medicaid HMO)
- Medical Partners of America (MPA)
- Great West HealthCare PPO/HMO/POS (formerly One Health Plan)
- Principal Edge
- Private Healthcare Systems (PHCS)
- Southcare/Coventry Healthcare of GA
- State Health PPO, High Deductible PPO (high option) and Managed Indemnity (HMO/ PPO plans in UnitedHealthcare network)**
- Tricare/Champus PPO
- Unicare
- United Healthcare
How much is an office visit?
Since every visit is different, we prefer to give you a guide to help estimate the cost. Here are some figures to help estimate the approximate cost of office visit:
| Patient | New Patient Fee Range | Established Patient Fee Range |
| Physician Office Visit Fee | ||
| Annual Exam | $185-$235 | $160-$190 |
| Problem Visit | $70-$195 | $50-$150 |
| Lab tests | ||
| Pregnancy Test | $25 | $25 |
| Pap Test | ||
| STD Panel | ||
| Supplies | ||
| Gardasil Injection (for a series of 3 injections) | $640 | $550 |
| Ultrasound | ||
| Ob Ultrasound | $125-350 | $125-$350 |
| Gyn Ultrasound | $190 |
What is the difference between coinsurance and copays?
The terms "coinsurance" and "copays" apply to a feature in some health insurance benefit plans that require the patient to share the cost of medical services with the insurance company. Typically, coinsurance is calculated as a percentage of the charges for medical services rendered. Coinsurance is commonly associated with inpatient hospital stays and major medical procedures. Copays are fixed amounts paid by the patient, regardless of the amount charged for medical services rendered. Copays are commonly associated with physician office visits, prescription drug or some hospital services.
What is included in the maternity fee? What is not included?
These medical services are included in the global fee for maternity care:
- Routine prenatal care, including regular recording of weight, blood pressure, fetal heart tones and urine chemistry, monthly visits through 28 weeks gestation, bi-weekly visits to 36 weeks gestation and weekly visits until delivery.
- Labor and delivery of your baby, including admission to hospital, admission history and physical, management of uncomplicated labor and vaginal or cesarean delivery.
- Routine Post-partum care (up to 2 visits)
If we treat you for a medical or surgical complication of your pregnancy, the medical services we provide are not included in the global fee for maternity care. These services are billed separately and, depending on your insurance, you may be required to pay a copayment.
Some common examples of medical complications of pregnancy that are billed separately are: hyperemesis (nausea and vomiting), hypertension (high blood pressure), gestational diabetes, pre-term labor, premature rupture of membranes and cardiac problems.
Examples of surgical complications of pregnancy that are billed separately include appendectomy, hernia, ovarian cyst, and bartholin cyst.
What is a global fee?
A global fee refers to one fee paid to provide medical services for an entire episode of care. In our office, the most common service subject to a global fee is the Supervision of a Routine Pregnancy.
Typically, we are paid a global fee for all routine prenatal care and the delivery of the baby. An important consideration here is that patients may experience complicated (or non-routine) pregnancies. Some of the services provided for "non-routine" care would not be included in the global fee arrangement. Those services would be billed separately. More than likely, a patient copay would apply.
Can I have my annual exam at the same time as a problem visit?
If you are scheduled for an annual well woman exam and have a problem you'd like to discuss, be sure to tell your provider. If it is a minor issue, a vaginal infection, for example, she will probably treat the problem at the same time. If your problem requires more time and discussion-pelvic pain, for example-she will probably ask you to return for a future appointment. If the problem is a higher priority for you, you can certainly ask your provider to address it instead of completing an annual exam.
Can you bill me for my copayment?
Your copayment will be collected at the time you appear in the office for your visit. We do not bill patients for copayments. Please be prepared to pay your copay (and show you insurance card) when you come in for an appointment.
What is a deductible?
The deductible refers to the amount of money that you (the patient) must pay for medical services you receive before your health insurance company pays claims on your behalf. This is usually a yearly amount. Once you have "met your deductible," any medical claims subject to the deductible will be paid by the insurance company. Some services, like doctor visits, may not be subject to a deductible. Usually there are separate individual deductible amounts and total family deductible amounts.
What is a pre-existing condition and why does it matter to me?
The term "Pre-existing condition" refers to a patient's diagnosis or condition that preceded the start date of her insurance coverage. This is an important issue for patients who have recently changed (or added) insurance coverage. An insurance company may not pay for medical services associated with a pre-existing condition at all or during a waiting period.
If you have recently changed (or are planning to change) your insurance coverage, you should look carefully at the plan's rules on pre-exiting conditions. Pregnancy commonly appears on insurance company lists of "pre-existing" conditions that are not covered, at least for a certain time period. This is most likely to occur if you are self-employed or purchase an individual health insurance plan. If you are in this situation, you may end up paying out-of-pocket for your pregnancy-related medical services entirely.
Why was I billed a copayment during my pregnancy?
You probably were treated for a pregnancy complication that falls outside the scope of routine pre-natal care. Most insurance companies pay physicians one fee (a global fee) for all routine prenatal care and the delivery. If a pregnant patient is treated for other medical conditions during the pregnancy, the physician will bill separately for those services.
In many cases, the office visit for the separate services includes patient copay. Some common examples of medical complications of pregnancy that are billed separately are: hyperemesis (nausea and vomiting), hypertension (high blood pressure), gestational diabetes, pre-term labor, premature rupture of membranes and cardiac problems.
If you come in for a regular OB visit and are then treated for other symptoms (based on information you provided), the visit will likely be billed as a problem visit and, if indicated by insurance coverage, a copayment will be billed to you.
Will the payment I make to AWS cover the hospital fees also?
No. The Hospital fees are billed by the Hospital. For more information on the hospital-related charges please visit the Northside Hospital billing page.
Does my insurance company cover certain services?
Patients call us often to ask if a certain service, (infertility treatments, for example), are covered by their insurance plan. Unfortunately, we do not have ready access to the information on everyone's benefits plans.
We recommend you contact your insurance company directly. If you have employer-paid insurance, the human resources department is also a good resource for this information. Sometimes you may need to have a specific billing code in order to get accurate information. We'll be happy to help you with that information.
What payment arrangements do you offer for OB patients?
We offer payment plans for patients who have large out-of-pocket costs associated with a pregnancy or a major surgery. The most common plan is to allow you to pay your out-of-pocket costs in 4 installments. These installments must be paid by the time your pregnancy reaches 20 weeks.
Can I use my spouse's insurance rather than my insurance?
If you have health insurance and are the subscriber, you must use it as your primary insurance coverage. The bills must be filed with your insurance first. If you are also enrolled in your husband's plan, you can use it as secondary coverage. If there is a balance due after your insurance pays, it can be billed to this coverage.
Insurance companies attempt to "coordinate" benefits between each other. They share information in order to verify which carrier should be responsible for payment on behalf of a patient. If you are covered by two plans you have likely received letters of inquiry from one or the other carrier asking you to verify your insurance plan(s).
Why was this charge considered non-covered by my insurance company?
Your health insurance benefits are determined by the insurance company that provides them. They typically provide a list of services that are not covered (excluded) by your plan. If you receive a service that is not covered by your insurance plan, you will be required to pay.
Some examples of services that occasionally appear on non-covered lists are:
- Infertility treatments
- Birth Control
- Routine Wellness Visits
We recommend that you check with your insurance company to verify that the services are covered.
I have a question pertaining to some lab charges.
Contact the lab directly, we use Quest Diagnostics Laboratory and Laboratory Corporation of America (LabCorp). If you received a bill for lab services from our billing company, you may contact a representative directly. Also, you can reach our lab manager via web message or phone.
