Billing and Insurance

This is a list of payers that Children’s is contracted with as of March 1, 2025. Please note that this list is subject to change. Please contact your payer:

1. To directly clarify the coverage and any limits required by your specific benefit plan.
2. If you have any questions regarding your coverage.

You should contact your payer to verify coverage prior to obtaining any non-emergency department services. If your payer has not included Children’s in your network, then prior to service, your payer may still approve coverage for treatment with an out-of-network authorization and single case agreement.

A payer cannot require prior authorization for emergency services provided at Children’s.

Georgia Medicaid and CMO Plans:

• Traditional Georgia Medicaid
• Amerigroup
• CareSource
• Peach State Health Plan

 

Commercial Insurance (Including the Health Insurance Exchange):

• Aetna/Coventry/First Health
• Ambetter
• Anthem Blue Cross Blue Shield
• CareSource Marketplace
• Cigna (including Cigna + Oscar)
• Kaiser Permanente
• Multiplan/PHCS/Beech Street
• Novanet
• Oscar Health Plan
• Secure Health
• Sidecar Health
• United Healthcare*
• Veracity Benefits

*Please note: Contracted plans exclude short-term limited duration benefit plans, limited benefit plans, provider, ancillary or physician only plans, and share plans. Please confirm network participation directly with your payer.

 

TRICARE:

• TRICARE Select
• TRICARE Prime (including remote)

Please note: Children’s does not participate in the TRICARE Autism Demonstration Project.

 

Medicare:

1. Arthur M. Blank Hospital and Scottish Rite Hospital are enrolled in Traditional Medicare.
2. Children’s does not participate in Medicare Advantage plans.

 

This is a list of payers that Hughes Spalding Hospital is contracted with as of May 1, 2025. Please note that this list is subject to change. Please contact your payer:

• To directly clarify the coverage and any limits required by your specific benefit plan.
• If you have any questions regarding your coverage.

You should contact your payer to verify coverage prior to obtaining any non-emergency department services. If your payer has not included Hughes Spalding Hospital in your network, then prior to service, your payer may still approve coverage for treatment with an out-of-network authorization and single case agreement.

Please note that the physicians who provide services at Hughes Spalding Hospital independently bill and collect from payers for their services, and may not participate in the same networks as Hughes Spalding Hospital.

A payer cannot require prior authorization for emergency services provided at Hughes Spalding.

Georgia Medicaid and CMO Plans:

• Traditional Georgia Medicaid
• Amerigroup
• CareSource
• Peach State Health Plan

 

Commercial Insurance (Including the Health Insurance Exchange):
Please note this excludes short-term limited duration benefit plans, limited benefit plans, provider, ancillary or physician only plans, and share plans. Please confirm network participation directly with your payer.

• Aetna/Coventry/First Health
• Ambetter
• Anthem Blue Cross Blue Shield
• CareSource Marketplace
• Cigna
• Kaiser Permanente
• Oscar Health Plan