Insurance and Billing
Carolina Kids currently accepts most plans offered by the insurance carriers listed below:
- Blue Cross & Blue Shield
- Blue Value
- Cigna (Effective 1/1/2021, we will no longer participate in Connect)
- Duke Select (we can file but we are not a Duke preferred provider)
- United Healthcare
We currently do not accept new Medicaid, NC Healthchoice, Christian Care Ministries, Bright Healthcare, or Tricare.
If you are a patient searching for a practice that accepts new Medicaid, please see this DHHS list.
We currently do not accept any Ambetter, or international policies (such as GeoBlue). If your policy has changed, please check with our office prior to any appointments.
While your carrier may be listed above, due to constant changes in healthcare plans, we cannot guarantee that we are in network with your specific plan or able to submit claims on your behalf.
See our Insurance and Billing 101 for more information.
Many insurance plans apply deductibles/co-insurance to testing or procedures performed during your visit. Separate codes are used for add-on items and are not included with the exam, even if performed at a scheduled well-exam. See our parent handout on Deductibles/Co-Insurance for more information.
Medicaid and NC Healthchoice
Carolina Kids is contracted with the UnitedHealthcare Community Plan and WellCare so we may continue to see our existing Medicaid patients. NC Healthchoice will merge with Medicaid effective 04/01/2023.
Medicaid Unwinding begins April 1, 2023
A federal law passed in response to COVID-19 made sure that no one has lost their Medicaid coverage since 2020 – however, changes are coming and families who are no longer eligible or who cannot be reached could lose their coverage.
What This Means for You Medicaid is going to review everyone’s coverage over several months. It is very important that Medicaid can contact you, and, if you are contacted, that you reply immediately to requests for information. If you do not respond you could lose coverage, even if you are still eligible. If you are told you are no longer eligible for Medicaid, you might still be eligible for other free or low-cost coverage.
Steps You Should Take to Stay Covered
- Update your contact information now. Visit the NC ePass website at https://epass.nc.gov/ or call (888) 245-0179. Do this right away and any time you change your mailing address.
- Reply immediately to any requests. Medicaid might contact you via text, email, phone, or mail to check information related to your eligibility or to ask you to fill out a renewal form – please reply to these requests right away. If you need help, visit https://localhelp.healthcare.gov/ and enter your zip code to find assistance. (If you have concerns that any messages are legitimate, check them against the state’s website or phone number).
- Ensure you and your family have coverage. Medicaid will check to see if you’re eligible for other programs if you are no longer eligible for coverage. However, if you lose your coverage, check for other options. Visit https://healthcare.gov for other affordable coverage options.
- Check your new provider network. If you are selecting a new plan, and wish to stay with Carolina Kids Pediatrics, make sure that we are in network with your new plan. Carolina Kids is currently in network with Medicaid Direct, United Healthcare Community Plan, and WellCare.
State Info to Help Families Update Contact Information
Medicaid Unwinding (recertification) Fact Sheet
Carolina Kids Letter to Parents of Patients
Is your child uninsured and you need help obtaining an insurance policy?
The N.C. Department of Insurance offers assistance to families with finding, choosing, and obtaining insurance.
List of Insurers Offering Individual Health Insurance (link updated 3/23/21)
Glossary of Common Insurance and Medical Terms
We accept checks, cash, or credit cards. Please call and speak to our office staff if you have any billing questions.