Billing & Insurance

We are contracted with many different insurance plans and will file for reimbursement. It is your responsibility to know the details of your health insurance plan with regard to referrals, co-payments, deductibles and percentage of coverage.

We require your co-payment at the time of your visit. In addition to cash and checks, we also accept VISA, MasterCard, American Express, and Discover.

North Atlanta OBGYN is part of the Atlanta Women’s Health Group (AWHG). If you have insurance payment questions or need assistance with your account balance please call 404.303.7520 at AWHG’s Central Billing Office.

To make an account payment online click here to access Atlanta Women’s Health Group secure online bill pay.

Billing for Laboratory procedures: All laboratory procedures are billed separately from your office visit. You could receive a laboratory bill from any of the following:

Phytest: 404-943-0205

LabCorp: 1-800-845-6167

Quest: 1-800-326-4756

If you receive a bill from one of the labs listed above, please call the listed number for questions. If you still have a question and need additional help, please do not hesitate to call our office at 404-255-0621 and ask for billing.

• Aetna-HMO, PPO, POS, Aetna Premier Care Network
• Aetna- Qualified Health Plan (QHP) - (Market Place plans-Aetna Gold, Silver, Bronze)- AWHG is NON-PAR
• *PLEASE NOTE THAT AWHG and Northside Hospital are NON-PARTICIPATING with these plans
• Aetna CVS Health Plan *Go by the "network" that is listed on the card. If QHP (Gold, Silver, Bronze) is on card - AWHG is NONPAR. If HMO or PPO is on card, AWHG is PAR.
• Aetna-EMORY Health Plan - AWHG is a TIER 2 provider
• Aetna Medicare Advantage-Some of our doctors are PAR with Aetna's Medicare Advantage products. Please ask me for a current list.
• Aetna Medicare Dual Preferred Aetna Medicare Select
• Aetna Medicare Advantra Preferred
• Aetna Medicare Choice Plan
• Aetna Medicare Essential Plan
• Aetna Medicare Plus Plan
• Aetna Signature Medicare PPO
• ALLIANT - AWHG is non-participating with all ALLIANT products (including the ALLIANT PPO, Solocare, and Simplecare offered on the Exchange). AWHG terminated this contract as of 9/26/19. We are still participating with HEALTH ONE ALLIANCE (HOA Network) which is their PPO.
• Ambetter - AWHG NON PAR - Gold, Silver, Bronze - Exchange/Marketplace plans
• Ambetter - only the following practices are participating with Ambetter: GWOB, AGYN, TWGG, MGYN, WHA, AOBG. These practices are PAR in Ambetter Core Product. These practices are Non-Par in new 2022 plans called Ambetter Select and Select Plus.
• Ambetter - OGAM only is enrolled thru Wellstar for Ambetter Core and Ambetter Select as Feb,1 2023
• BCBS (PPO,HMO, HPN, PAR, Anthem Health Access Plans, Pathway Gold, Silver, Bronze plans, Pathway Guided Access HMO (gatekeeper product), PATHWAY X Guided Access HMO exchange products (gatekeeper product), BLUE DIRECT, BLUE OPEN ACCESS)
• BCBS - HPN - High Performance Network (effective 1-1-21)
• BCBS - PATHWAY X - Guided Access HMO -Exchange Products
• AWHG does not participate Blue Value Secure or BCBS Medicare Advantage HMO
• BCBS GA Alternative Network-(same as Open Access-AWHG is in-network)
• CareSource Marketplace/Exchange plan (Gold, Silver, Bronze) & CareSource Medicaid plan
• CHAMPVA - There is no participating list of doctors for this program. AWHG can see these patients.
• Choice Care Network-Humana's national network
• Cigna-Cigna products include HMO, PPO, Open Access Plus, Cigna & Oscar Open Access Plus Plan
• Cigna & Oscar Open Access Plus Plan (Exchange/Marketplace plan)
• Cigna-Piedmont employees 2023-We can see Piedmont Choice plan-Cigna Open Access Plus-We are Tier 2. We cannot see Piedmont Exclusive plan.
• Cigna-EPO, Local Plus, Simple Choice, Cigna Connect Bronze, Silver, Gold -AWHG is NON PAR
• *ID cards with Cigna Pathwell Specialty Network- if we are PAR with plan listed on front of card (i.e.HMO, PPO) then we are PAR with the exception of providing infusion & specialty drugs
• ClaimsDoc - (for Kings Ridge Christian School, City of Hapeville, etc..)
• Coventry HMO
• Custom Design Benefits
• First Health Network
• Great West Life (now called Cigna-Great West Life)
• Health One Alliance (HOA Network which is their PPO)
• Health Plan Select (Athens Area Health Plan Select)- termination of coverage in Athens as of January 31, 2016 - WHA was directly contracted for OB/GYN services. AOBG was contracted for only GYN services.
• Humana - Wellstar (AWHG is not contracted to see Wellstar patients. This is a separate network for Wellstar employees. Patients are only to see Wellstar doctors.)
• Humana - Gold Choice, Choice PPO, and Humana Gold Plus (AWHG NON-PAR. These are Humana's Medicare Plans.)
• Humana-HMO, PPO, OPEN ACCESS, PREFERRED OPEN ACCESS, AND PREMIUM MANAGER PLUS, POS, and all HUMANA CHOICE CARE.
• Humana-TriCare Standard and Tricare Prime
• Humana - TriCare for Life-MEDICARE product-AWHG NON PAR
• Kaiser - (AWHG NON-PAR )However, AWHG can see Kaiser Dual Choice PPO patients who have the PHCS/MultiPlan logo on their ID card.
• Kaiser - (AWHG NON-PAR ) Gold, Silver, Bronze / Exchange-Marketplace plans
• Kaiser - WHA & AOBG only -Athens only - WHA bills under TIN 45-4102348
• MEDICARE - AWHG gives each individual physician the option to OPT IN or OPT OUT of Medicare. Please check with your POD manager.
• Medicaid
• MDI Healthcare Solutions (formerly Medical Partners of America network for MAG Mutual employees only)
• Mercer University - P1 Network Patient First Network
• MULTIPLAN (merged with PHCS and BeechStreet - 2011)
• MULTIPLAN discount program (Value Point) - Optum Health Allies, United Health Allies, Health Allies, AARP
• Collect the MultiPlan allowable at the time of service from the patient. Look for the Optum Health Allies, United Health Allies or Health Allies logo on the ID card. AARP is utilizing this discount program.
• Northside Health Network - (all POD's are in-network EXCEPT OGAM, AGYN, AOBG, and WHA) (our physicians are considered Tier 1)
• "Northside Hospital employee benefit plan - 2024- employee plan uses Northside Health Network and Anthem's physician network called Blue Open Access POS - our physicians are considered Tier 1
• NovaNet
• Oscar - effective 8/1/23 - all Oscar metal tier plans (Oscar Gold, Silver, & Bronze)
• Partners Direct Health - AWHG is participating as of 4/1/2020 - (largest client is Signature Healthcare)
• P1 Network-Patient First Network - Mercer University
• Quik Trip
• Signature Healthcare - (see Partners Direct Health)
• Tricare- Tricare Select, Tricare Prime, Tricare Young Adult
• Tricare for Life- These patients should see a Tricare contracted provider who is also a Medicare participating provider.
• United Healthcare - HMO, PPO, Navigate, All Savers Alternate Funding Plan, W500 Benefit plan
• United Healthcare - Marketplace/Exchange plans - Gold, Silver, Bronze
• United Healthcare - as of 4/1/2023 our doctors are NON-PARTICIPATING with UHC Core plans and UHC Charter Benefit plans
• *PLEASE NOTE THAT AWHG and Northside Hospital are NON-PARTICIPATING with these plans
• United Healthcare -Some of our doctors are PAR with UHC's Medicare Advantage products. Please ask me for a current list.
• VA CHOICE - Veterans Choice Program- AWHG is non-participating
• VA Community Care Network - Administered by United Healthcare-new program 2020 for Veterans to get appointments outside the VA- AWHG is PARTICIPATING
• Wellstar Health Plan -2024 - AWHG is NON PARTICIPATING
• *PLEASE NOTE that the ID card has Anthem listed in the top left corner but this is only for out-of-state members who travel or live outside of the employee plan service area. It indicates that Anthem is the "wrap network" for out-of-state coverage only.
• For OGAM doctors only - OGAM is part of Wellstar Clinical Partners at Kennestone Hospital. OGAM doctors are in-network for the new Wellstar Health Plan in 2024 for employees. The ID card has Anthem listed in the top left corner but this is only for out-of-state members who travel or live outside of the employee plan service area. It indicates that Anthem is the "wrap network" for out-of-state coverage only.
• Amerigroup - Medicaid CMO
• PeachState - Medicaid CMO
• Peach State - PeachCare for Kids product
• CareSource - Medicaid CMO

• Deductibles are paid out of pocket each year before insurance kicks in. Each family member usually has a separate deductible.
• Co Payments are flat fees charged each time you visit the doctor or use any medical service, regardless of the cost of the procedure
• Coinsurance requires you to pay a percentage of the total cost of the care. Many plans require either co insurance or co pay but some charge both.
• Maximum out of pocket expense is the most you’ll have to spend before all of your medical bills are covered.