Insurance & Referrals

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Payment and insurance

We will submit all claims directly to your insurance carrier. Your insurance may require a co-pay which we will collect at the time of the visit. We will bill you directly for any portion of your bill not covered by your insurance company.

Please navigate to our bill pay page for more detailed insurance information: www.metropeds.com/billpay/

DETERMINING NETWORK STATUS

It is important for you to personally call your insurance to verify that we are in-network providers for your plan. Plan status changes occur frequently.

For 2024, we know we are NOT in network for the following specific plans, but this list may not be comprehensive.

Aetna Allina Health – out of network for specific plans

-Allina Elevate Plan [Allina Health]

Healthpartners- out of network for specific plans

-Commercial Select (Individual and Family) [PNMC/HP clinics]

Preferred One – out of network for all plans

Medica – out of network for specific plans

– North Memorial Acclaim by Medica [North Memorial clinics]

-Clear Value [Hennepin Healthcare]

-Medica CompleteHealth [Mayo Clinic]

-Engage by Medica [Mayo Clinic Health System]

-North Memorial Acclaim by Medica [North Memorial clinics]

-Ridgeview Distint [Ridgeview]

-Bold by M Health Fairview [M Health Fairview]

UCare– out of network for specific plans

-UCare Individual & Family Plans with Fairview

UMR- out of network for ALL plans

-While out of network, we are working on becoming network providers but cannot currently guarantee network status.

UnitedHealthcare- out of network for specific plans

-UHC Core and Core Essential

Referrals

Your medical coverage may require that you obtain an Insurance Referral for services that our physicians recommend. The best way to ask for a referral is to email us at referral@metropeds.com. Please include your name and contact information as well as your child’s name, date of birth, the reason for the referral, and the details of any specific providers you wish to see.

We are working on increasing availability of our referral coordinator by phone, but at this time only voicemail is available. Please call any of our clinic locations and ask to be connected to the referrals line. For efficient service, please ensure you leave the information above on the voicemail.