Insurance & Billing

Insurance Participation

When you sign up for your insurance coverage, please make sure that you read the rules thoroughly, and select the plan carefully. Once you have signed an insurance contract, you have agreed to follow its rules and regulations. As such, it is important that you understand the following: Home > Insurance & Billing Insurance Participation When you sign up for your insurance coverage, please make sure that you read the rules thoroughly, and select the plan carefully. Once you have signed an insurance contract, you have agreed to follow its rules and regulations. As such, it is important that you understand the following:
  • Which Doctors and Hospitals Participate with your Insurance

    Insurance companies sign contracts with hospitals and doctors for their members care. These doctors that agree to participate with a given insurance plan, become the plan's network. Your insurance company may not pay if you go to a provider outside of the plan's network. If your insurance mandates the selection of a primary care provider, you must choose a doctor prior to your first office visit. If you do not choose a physician before your first visit, it may result in non-payment by your insurance company, and you will be responsible for the services provided.
  • Rules for Seeing Specialists

    Many plans will not pay for a consultation or treatment received from a specialist, unless a referral is issued by your primary care provider, and authorization is given for the service. If you see a specialist without a referral, or prior to receiving authorization, you may have to pay for the visit. It is imperative that you make sure that the specialist participates with your insurance plan.

  • Prescription Medications

    Every insurance company has a list of approved medications that they will cover. This list is called the formulary. If a medication prescribed is not included in an insurance formulary, then the insurance company may refuse to pay for it, or request that you pay a higher co-payment. At times the insurance company will require a pre-authorization from your provider.
At Carroll Family Medicine, LLC. we participate in many managed care plans, and see patients with traditional insurance. The detailed list of insurance plans provided below, covers all of the major plans accepted our practice.

If you still have any questions regarding insurance plans, referrals, and payment responsibilities please do not hesitate to call the office and speak to our trained, and courteous office staff.

Insurance Companies Accepted



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