Insurance coverage for your visit

Before your child's appointment, become familiar with your insurance plan policies as there are several types of insurance plans including PPOs, POSs and HMOs, and each insurance company has its own policies. Here are a few tips for making the most of your insurance plan:

Referrals
Check with your insurer to see if you need a referral for your appointment (referrals usually come from your child's pediatrician or a referring specialist). If you do, make sure you have the referral before you come to your appointment. If the referral is in writing, bring a copy of it with you to the appointment.

Medical procedures
If your child's doctor orders a medical procedure, ask him or her to provide you with a written copy of the medical orders. This helps to ensure the procedure is done efficiently, and is important for your insurance records. Without written orders you may need to reschedule the procedure.

Having the procedure
If your child is sent for a procedure, make sure your insurance company will pay for it to be done at Children's Memorial. The hospital has doctors, nurses and staff trained to use custom equipment for kids which may need to be explained to your insurance company. If the insurance company objects, but your doctor wants the procedure completed here, have your doctor write a "letter of medical necessity" and fax it to your insurance company.

Chronic medical conditions
If you have a child with a chronic medical condition, you may want to check with your employer to find out which of your company's insurance plans gives you the most flexibility and best coverage.