Raleigh Neurology Associates, P.A., is a Medicare provider and accepts most major insurance plans. The list below indicates the carriers that Raleigh Neurology is contracted with to provide medical service for patients. In order to assure that Raleigh Neurology can provide service, we require current insurance information before the time of service. Please note, just because Raleigh Neurology is contracted with an insurance carrier does not guarantee that Raleigh Neurology is in network with the patient’s specific plan, even if it is provided by one of our contracted carriers. The patient must be responsible for knowing their benefits and whether or not Raleigh Neurology is in network for their plan. We ask that patients please call the number on the back of their insurance card to verify coverage or the requirement for a referral.
We do not accept any Workman’s Compensation or motor vehicle accident cases in our clinics.
In order to file an office visit to insurance, the patient must be physically present at the appointment. This includes pediatric patients returning for testing results.
Click here to read about BCBS’s Transparency in Coverage Rules
Insurance carriers include:
- Aetna
- Blue Cross Blue Shield of North Carolina
- BCBS State Health Plan – Raleigh Neurology Associates is listed as a Non CPP provider for copay
- Carelink CoventryOne Duke POS – Tier 2
- Cigna Healthcare
- First Carolina Care
- Gateway
- Humana Choice Care Network
- MDI
- MedCost
- Medicaid-NC Medicaid Direct
- NC Medicaid Managed Care Plans: Healthy Blue (NeuroOpthalmology is unable to accept this specific BCBS plan), United Healthcare Community Plan, AmeriHealth Caritas, and Carolina Complete Health, WellCare Medicaid
- Medicare (including Railroad and United Mine Workers)
- Project Access (Pediatric Dept. does not participate)
- United Healthcare
- WellPath Coventry (includes Southcare PPO, First Health, Healthcare Preferred)
Unfortunately, we do NOT accept/participate in the following insurance plans or cost sharing networks:
- Aetna Medicare Prime HMO
- Aetna – Duke Basic or Duke Select Open Access
- Blue Local – With Carolinas Healthcare System
- Blue Local – With Duke
- Blue Local – With WakeMed
- BCBS Blue High Performance Network
- Cigna Connect HMO
- Cigna Healthspring Medicare
- Humana Gold Plus HMO (certain plans may be acceptable)
- Medicaid plans outside of North Carolina
- Medishare
- Multiplan
- PHCS
Medicare Replacement Plans
Raleigh Neurology Associates, P.A. will file most Medicare Replacement plans as a courtesy to the patient. There may be times where, at the discretion of the management at RNA, we will not file a patient’s Medicare Replacement policy.
We are contracted with the following Medicare Replacement Plans:
- Advantra
- Aetna Medicare
- BCBS Medicare Choice (replacing Partners MCR Choice eff. 1-1-08)
- Cigna Medicare Access
- Evercare
- Humana Gold Choice
- Secure Horizons
- Today’s Options
- UHC Medicare Complete
Any other PFFS (Private-Fee-For-Service) plans we will file as a courtesy but do not have a contractual obligation to file. These plans will pay based on the current Medicare Fee Schedule and Raleigh Neurology will accept this fee schedule for these PFFS carriers. This does NOT mean that RNA will accept their insurance companies’ payment as payment in full, it simply means that we will not bill the patient for any amount determined to be “over and above customary” by their insurance company.
Some of these PFFS plans require authorization, if it is NOT a plan that we have a contract with then please inform the patient that they are out-of-network and have waiver signed each time they present to Raleigh Neurology for medical care.
Medicare Prescription Drug Coverage (Part D)
There are over 50 different Prescription plans available to North Carolina residents.
Raleigh Neurology understands the difficult choices our patients face regarding their prescription drug coverage. Although we cannot directly advise our patients which plans would be best suited for them, we would like to assist you by providing some helpful contact numbers.
For personalized information on how to choose a Medicare prescription drug plan contact:
1-800-Medicare (1-800-633-4227),
or www.medicare.gov
NC Senior’s Health Insurance & Information Program (NC SHIIP) at 1-800-443-9354