How Can I verify if a AAAM is in My Coverage Network?
- You will need our Tax ID Number: 01-0368851
- Confirm with the agent that Allergy and Asthma Associates of Maine (what provider you will be seeing link to providers) is in your network, not just if the provider is covered by that insurance plan.
- Ensure that you document the agent's name and identification and ask that this be sent to you in writing.
- If we are not in network, you do have options, please reach out to our billing team to assist at (207) 774-9839 EXT. 5
Common Codes in the Allergy and Asthma Specialty
- 95004-Allergy Testing $9.24
- 95117-Allergy Injections $24.28
- 95165-Serum (Vials) $28.88
- 95044-Allergy Patch Test (per) $9.70
- 95076-Oral Challenge (120 Minutes) $242.64
- 95079-Oral Challenge (60 Minutes) $167.18
- 95044-Ice/Heat Challenge $9.70
- 94010-Spirometry $53.74
- 94060-Spirometry Challenge $76.90
- 94640-Nebulizer Treatment $17.00
Most Common Insurances
- Anthem Blue Cross Blue Shield
- Anthem BCBS Federal
- Aetna
- Cigna
- United Healthcare
- Martins Point
- Harvard Pilgrim Healthcare
- Medicare
- Medicaid (Mainecare)
- Martins Point Generation Advantage
- Meritain Health
- VA (Veterans Affair)
- Maine Community Health Options
- Tufts Health Plan
- UHC Medicare Solutions
- UltraBenefits, Inc.
- LHI (skin testing only and no breathing tests. These are scheduled with Dr. Musmand ONLY).
- AARP Medicare Complete
- AARP Medicare Supplement
- Health Plans
- Beacon Health
- ChampVA
- Colonial Penn Life Ins. Co.
- GEHA
- WellCare Healthcare
- Mutual of Omaha Insurance Company
- MEMIC (Workers Comp)
- Oxford Health Plans
- Patient Advocates (PHCS)
- TRICARE East Region
- TRICARE-West
- UMR
- We do not accept NH, VT, MA or any other states Medicaid. Only Maine!
Care Partners
CarePartners is a form of financial assistance program for patients who are unable to pay for personal insurance or receive state Medicaid. We ONLY see 1 patient per month. The patient is responsible for a $10 copay at the first visit and financial hardship paperwork and demo packet are mailed to them.
CarePartners is only good for the FIRST visit. If subsequent visits are needed, the patient will be responsible for making payment arrangements with our billing department. This must be documented in the billing screen along with the end date of their eligibility with CarePartners in case they need to be seen prior to the end date.
FreeCare
FreeCare is another financial assistance program through Maine Medical Center (MMC-FreeCare or Uncompensated Care). This must be verified prior to patient being scheduled to make sure their FreeCare is active. FreeCare is only good for the FIRST visit, and they will be responsible for making payment arrangements if subsequent visits are required. Document in their billing screen and note if coverage has an end date in case, they need to be seen prior to the end date. Financial hardship paperwork will be mailed to patient. ONLY 1 FreeCare patient PER PRACTICE PER MONTH.
Health Care Insurance Glossary
Copay – A copay is a set dollar amount that you pay for a medical service or product, such as a doctor’s visit or a medication. You will usually pay this at the time of your visit. For example, your copay each time you see the provider.
Coinsurance – Coinsurance is a percentage (%) of a medical charge that you are responsible for paying. For example, if you have a 20% coinsurance and have met your deductible, you will pay 20% of that charge. If a visit costs $150, you will pay $30 (20% of $150) as your coinsurance.
Deductible – A deductible is an amount you are required to pay before your insurance will pay towards your expenses. For example, some plans have a $2,000 per year deductible. Once you reach this amount, your insurance will then pay for covered services, minus any copays or coinsurance you may be responsible for.
Explanation of Benefit (EOB) – A mailed or online document that explains what was paid to the medical provider for a service or product, based on your plan coverages. If you owe the provider anything, it will be outlined in this document. Your bill from the doctor and your Explanation of Benefit should be the same dollar amount. EOBs can be inherently difficult to understand; if you need help call the insurance company.
High deductible health insurance plan – High deductible plans have a higher deductible, for example $4,000 or $5,000 per year, but may be less expensive to buy (they have a lower premium). With these types of plans, you may also be able to set up a pre-tax Health Savings Account (HSA) through your employer. You can use the HSA to help pay for your medical expenses now or in the future.
Out-of-pocket maximum – Out-of-pocket maximum is the maximum amount you would pay per year for medical expenses based on your insurance plan. Once you meet your out of pocket maximum, the health insurance company then pays for 100% of covered medical expenses. Yo u no longer have copays or coinsurance.
Health insurance premium – Your health insurance premium is the dollar amount you pay for medical plan benefits. This may be taken out of your paycheck if your employer provides health insurance, or the government may take it out of your social security if you have Medicare. Part C premiums are billed through the private insurance company associated with your Medicare Advantage plan.