Preparing for the Financial Aspects of CHD

When a family learns that their child has a congenital heart defect, the financial considerations of that serious diagnosis is often the last thing on their minds. However, along with providing world-class pediatric cardiac care and treatment, Children’s Healthcare of Atlanta Cardiology walks with families every step of the way, including helping them to prepare financially.

“The first thing they should know is, like any time their child gets sick, they need to ask themselves, ‘What insurance do I have, what is my deductible, what will I owe and what are my options?’” said Teresa Traugott, Senior Business Office Manager at Children’s Healthcare of Atlanta Cardiology.

Even when families have excellent health insurance coverage, few will leave the hospital with a zero balance. Some families have low-cost health insurance plans with deductibles as high as $10,000, which can be a heavy burden after a heart surgery and stay in the hospital.

“Ask questions up front if you can,” Janine Greenhill, Business Office Manager, said. “Sometimes a parent gives birth to a child with health problems, and they don’t know what to ask or expect. But on return procedures and office visits, you can ask, ‘What am I going to owe?”

If a family receives a medical bill that they don’t understand, it is recommended to follow up with the insurance provider directly. If that doesn’t answer their questions, parents can call the phone number on their bill.

Children’s Healthcare of Atlanta and Children’s Healthcare of Atlanta Cardiology offer generous financial assistance based on certain qualifications such as family size and income level. Traugott said she encourages people with a large bill to proactively seek financial assistance. She also recommends getting in touch with a cardiology who can identify resources to help.

“The social worker can stretch your resources well beyond the bill itself,” Traugott said. “If we know what your situation is and what your worries are, we can best address them to make life a little easier for families. There is an awful lot of help out there, and people just don’t know it. Don’t be afraid to ask.”

Frequently asked questions:

How much will my child’s visit cost?

The cost depends on the services required to diagnose or treat your child’s condition. How much you pay for your child’s visit depends on your insurance plan, and most healthcare plans require a co-pay or an annual deductible be met.

How do I obtain an estimate?

If you have insurance, check with your insurance carrier or contact the Financial Counseling Team to help determine your out-of-pocket cost or to obtain an estimate if you are self-pay. The estimates team can provide the necessary CPT codes to help families understand their medical bills better.

Financial Counseling Team

404.256.2593 — Extension 8008

Do I need to tell my insurance carrier I’m coming?

There are several important steps that families need to take as they prepare for the financial aspects of treatment.

Children’s Cardiology accepts most major insurance plans, however, if your plan has a set list of physicians you may visit, confirm that we are on the list.
Give your insurance provider the following: Children’s Healthcare of Atlanta Cardiology Tax ID# 58-1871713 and Our NPI# 1235148727
Keep in mind some insurance plans require pre-approval before a patient can be seen. The insurance plans below are examples of plans that require an approval before you arrive for your appointment.
- BCBS HMO
- Humana HMO
- Kaiser
- Tricare
Your insurance also may require a Contact your insurance carrier regarding how to obtain one. Note some plans require a PCP referral submitted to insurance directly prior to visit.

What do the following key terms mean?

Allowed amount. The amount your insurance carrier agrees to pay, the remaining balance will be adjusted.
Co-pay. A predetermined amount paid by a patient for receiving a healthcare service. This amount may vary depending on the specialty.
Co-Insurance. This is a generally a percentage of a medical charge that you pay, with the rest paid by your insurance.
How much you pay before your insurance starts to cover your bill. This normally resets yearly.
The amount of money charged by your insurance company for the plan you have selected.
Coordination of Benefits-COB. This is a process used by insurance companies to determine how to cover your medical expenses when you are covered by more than one health insurance plan.

How do I apply for financial assistance or government aid?

Visit the Billing and Insurance page to apply for financial assistance in English or Spanish. Also find out if you qualify for Medicaid or PeachCare for Kids.

Some helpful online resources include:

Can I pay my bill on MYchart?

Yes. Parents and guardians may now submit payments securely and conveniently through MyChart. Payments can be made by logging into the child’s MyChart account or by using the guest payment option, depending on preference.