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Insurance Networks We Accept
We DO NOT take straight
Florida Medicaid (Gold Card).
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We DO take the following Medicaid Plans:
Blue Cross Blue Shield HMO Medicaid
United Healthcare Medicaid
Healthease HMO Medicaid
Staywell PPO Medicaid.
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The Networks Below are in Effect (updated on 12-5-2011):
ACCOUNTABLE
AETNA
AVMED
CIGNA
FIRST HEALTH
FLORIDA HOSPITAL HEALTHCARE SYSTEM
BEECH STREET (NETWORK)
BLUE CROSS BLUE SHIELD (NETWORK)
BLUE CROSS BLUE SHIELD HMO -->MEDICAID*
COMPLETE HEALTH NETWORK
GALAXY HEALTHCARE
GREAT WEST/ONE HEALTH
HEALTHCHOICE (PPO, HMO)
HEALTHEASE HMO -->MEDICAID*
HUMANA
MULTIPLAN (NETWORK)
PHCS (NETWORK)
PPO NEXT
SOUTHCARE
SRC--> AETNA
STAYWELL PPO --> MEDICAID*
UNITED HEALTHCARE
UNITED HEALTHCARE--> MEDICAID*
*ONLY MEDICAID WE USE ARE THESE AND DR. RICHARD RODRIGUEZ MUST BE REQUESTED BY PARENT AS THE PRIMARY CARE ON
THESE PLANS
In Credentialing Process:
If your insurance plan is not listed here, please contact your insurance company and inquire what Insurance Network your plan is under. Many different plans will be under one network, if your plan is under that network then we would also be on their plan. Or, you can inquire with your insurance plan if our doctor is participating with that plan.
We appreciate parents informing us of any insurance changes in their family. Keeping us well informed with current copies of insurance cards and up to date information will greatly speed up your check-in process when you come in for your visit. We must be able to verifyyour child's coverage prior to their being seen by the doctor. In the event we are unable to verify your insurance coverage, you will have to pay for the visit at the time of service and submit to your insurance for reimbursement.
Thank you.
Sunshine Pediatrics
Billing and Insurance Department
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Florida Medicaid Clients - We DO NOT take regular, straight FLORIDA MEDICAID (the Gold Card), but you can call the member services number on the back of your Medicaid Gold Card to request a change in plan. Request one of the following plans United Healthcare Medicaid, Healthease HMO or Staywell PPO and request Dr. Richard Rodriguez as the Primary Care Provider. To help you in selecting the best plan that will afford you the most options, you should ask the member's services which of these plans has the most doctors on the plan.
It could take 4-7 weeks for this change to take effect, we cannot see your child till the change is effective. Those mother's covered by Florida Medicaid who give birth will have to have their baby seen by the Health Dept., Medicaid Clinic or another provider who accepts the regular, straight Florida Medicaid until the change takes effect.
This information is for educational purposes only and it should be used only as a guide.
Copyright @ 2006-2011 Sunshine Pediatrics
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