Insurance and Billing

If your question is not covered here, please feel free to call a representative at 513.246.7800 during our regular business hours: 9 a.m. to 5 p.m., Monday through Friday.

Patient registration 

  • To every appointment, bring your insurance card(s) – including Medicare/Medicaid, prescriptions – and a photo ID, such as a driver’s license, state-issued ID or student ID. Without an insurance card, you may have to pay for your visit that day.
  • Insurance co-payments and all out-of-pocket expenses are due on the day of your visit. A billing fee of $20 will be charged when co‑payment or out-of-pocket expenses are not paid the day of your visit.

Back to top 

Insurance coverage

  • Group Health Associates accepts all major insurance plans. See a list of plans here.
  • Contact your insurance company or call 513.246.7800 to see if Group Health participates in your plan.
  • If you have completed all insurance paperwork, we will bill your primary and secondary insurance companies. If your insurance does not pay your claim, you will be billed for the balance.
  • Group Health will assist you in the appeals process if your insurance company denies payment. Any questions regarding coverage or benefits should be discussed directly with your insurance company.
  • Contact our central registration at 513.246.7780 immediately with any changes to your insurance coverage, such as plan number changes, co-payment changes and name changes.

Back to top 

Balances after insurance

  • GHA will send a bill for services not covered by your insurance and for any out-of-pocket expenses or deductibles. These balances are due in full within 30 days.

Back to top 

Appointment cancellations

  • It is important to remember to cancel any scheduled appointment at least 24 hours in advance or you may be charged $50 for the missed appointment. To cancel an appointment, call 513.246.7000.

Back to top 

Radiology & Pathology

You may receive separate bills for reading of x-rays or for some lab services performed in a GHA facility. These charges are from providers that your doctor has asked to review your results – such as a pathologist or radiologist.

Back to top 

Claims coding

  • We cannot change codes so your insurance will cover the visit. Procedure and diagnosis codes are numbers assigned to services provided by medical professionals. We take great care to ensure accurate, ethical coding based upon your diagnosis and the procedures provided.
  • It is important that you understand your insurance coverage. You are encouraged to contact your insurance company to find out what services are considered cosmetic and/or are not covered.

Back to top 

Auto accidents

  • Medical expenses resulting from a motor vehicle accident are your personal responsibility.
  • GHA can provide claim forms upon request. Please call our billing department at 513.246.7800.

Back to top 

Paying your bill

  • GHA accepts cash, checks, American Express, Discover, MasterCard and Visa.
  • You may use a credit card to pay your bill by completing the credit card section on the bill or by calling 513.246.7800.
  • If you don’t have insurance, you will receive a 20-percent discount off your GHA charges if you pay in full at the time of service.

Back to top 

Billing questions

Our patient accounts department representatives are happy to help clarify any billing issues or questions. Please feel free to call a representative at 513.246.7800 during our regular business hours – 9 a.m. to 5 p.m., Monday through Friday.

Back to top 

Insurance plans accepted

  • As of May 2010, Group Health Associates accepts the following insurance plans. Exceptions and qualifications are noted.
  • If you have any questions, please contact your plan provider for specific answers. The contact number is usually on the back of your insurance card.

Aetna 

  • All providers participate in all Aetna plans.

Alliance Exclusive / Alliance Plus 

  • Contracted for Pediatrics and Pediatric referrals to specialists for children under 18 years of age.
  • Adults are considered out-of-network.

Amerigroup Community Care (Medicaid Product) 

  • Must have Group Health Associates provider listed on their card to be seen.
  • Must see a primary care physician (PCP) before seeing a specialist.

Anthem (including Anthem Senior Advantage – ASA) 

  • All providers participate in all plans.
  • Most Anthem plans have changed names to Blue products – Blue Priority, Blue Access, Blue Primary, Blue HMO (Federal), Blue Traditional

Beech Street 

  • PPO plan that is comprised of a network of affiliated payers.
  • Could have other names associated with plan. Patients’ card should show the Beech Street plan logo.

CAPP Care 

  • PPO plan that is comprised of a network of affiliated payers.
  • Could have other names associated with plan. Plan should have the CAPP care plan logo on.

Cigna 

  • All providers participate in all plans.

Indemnity Plans 

  • Indemnity plans, also referred to as commercial or traditional plans, allow patients to see any physician of their choice.
  • These plans never have a provider directory or primary care physician (PCP).

Direct Care America 

  • PPO plan.
  • Has other plans associated with plan; look for the Direct Care America logo.

Emerald Health 

  • PPO and EPO plans.

First Health 

  • PPO plan.

Great West/One Health Plan 

  • All providers participate in the PPO and POS.
  • Do not participate in the HMO plan.

HealthSpan 

  • PPO plan.

Humana 

  • Humana PPO.
  • Humana HMO.
  • Humana/ChoiceCare.
  • Humana/Newhealth.
  • Humana Gold & Choice (Medicare Products).

Medicaid
(Ohio Traditional, Qualified Medicare Beneficiary-QMB, Healthy Start) 

  • Must see primary care physician (PCP) before seeing a specialist.

Medical Mutual of Ohio 

  • Traditional, Classic, Super Med Plus.
  • Super Med Select and HMO.

Medicare 

  • All providers participate in traditional Medicare.

Nationwide 

  • PPO plan.

Ohio Health Choice 

  • PPO plan that is comprised of a network of affiliated payers.

Primary Health Services 

  • PPO plan.

Private HealthCare Systems 

  • PPO plan that is comprised of a network of affiliated payers.
  • Do not participate in the POS plan.

Public Health Systems 

  • All providers participate.

United HealthCare 

  • All providers participate in all plans.

Worker’s Compensation 

  • All providers participate.

Back to top 

Group Health Associates does not participate in:

Buckeye 

Caresource 

Discount Cards 

  • Card states “This is not insurance” or “Discount Card/Program.”

Molina Health Plan 

National Preferred Provider Network (NPPN) 

  • Group Health Associates is considered out-of-network.

Tricare/Champus 

  • Group Health Associates is considered out-of-network.

Back to top 

Obstetrics Billing

Insurance coverage for obstetrics
Group Health Associates accepts most major insurance plans. See the list here. You should contact your insurance carrier, visit our web site at cgha.com or contact our Registration Department at 513.246.7780 to see if Group Health Associates participates in your plan.

We will verify your insurance coverage and benefits to obtain your out of pocket/deductible cost related to your obstetrical care. You will be responsible for all co-payments, deductibles, and out-of-pocket expense not covered by your insurance.

For your convenience, we offer a payment plan of six equal installments. All outstanding balances must be paid in full prior to delivery.

Out-of-Pocket Limit – A predetermined amount of money that an individual must pay before insurance will pay 100 percent for an individual's health care expenses.

Deductible – Amount of loss that the insured pays before the insurance kicks in.

Coinsurance – For health insurance, it is a percentage of each claim above the deductible paid by the policyholder. For a 20-percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of the covered losses. After paying 80 percent of losses up to a specified amount, the insurer starts paying 100 percent.

OB billing/coding
Your OB care will be billed globally. These services include antepartum (before birth) care, delivery, and postpartum (after birth) care. The services are listed below. Any other services in within this time period will be billed separately.

If you should have a change in insurance, transfer care to another practice, or our physician does not perform your delivery, your charges will be billed outside the global billing services. This is an estimate for the doctors' fee only. This does not include the hospital or the anesthesiologist fees.

Delivery Fee 

$3,885.00 

U/S Lim Age

234.00

U/S Fetal Age

234.00

Non Stress (3)

98.00

Urine Dip (10)

60.00

Echo (2)

130.00

Venipuncture (10)

80.00

Estimated Total 

$5,002.00 

Radiology & Pathology
You may receive separate bills for reading of x rays or for lab services performed in a Group Health Associates facility. These charges are from providers that your doctor has asked to review your results – such as a pathologist or radiologist.

Paying your bill
Group Health Associates accepts cash, checks, American Express, Discover, Master Card and Visa. You may use your credit card to pay your statement by completing the credit card section of the statement or by calling 513.246.7800.

Patient Accounts Department
If you have any questions or need assistance with billing issues, please contact our OB coordinator at 513.246.7804 Monday through Friday, 9 a.m. until 5 p.m.

Living Will or Health Care Power of Attorney, contact Patient Relations at 513.865.1115. For legal advice, talk to your lawyer or contact Ohio Legal Services at 1.800.589.5888, Monday through Friday, 8:30 a.m. to 5 p.m.

Back to top