A pair of blue stars on a white background.

Insurance & Billing

Two hand drawn hearts on a white background.

Billing & Payment

GPM Pediatrics, PC wants to help you understand your medical bill and will always provide clear information regarding the billing details of the provided healthcare services. In order to assist you, we have defined common billing terms below.

  • Co-payments

    Co-payments are a contractual agreement between the policyholder and their insurance company. The co-payment is part of the payment, which is issued to your physicians. This payment is made at the time of your child’s appointment. Well visits are excluded from Co-payments unless otherwise instructed by your insurance carrier.

  • Deductibles

    Deductibles are an out-of-pocket expense. The amount of the deductible is based on the policyholders’ contract with their employer and their insurance carrier. There are in-network deductibles and out-of-network deductibles.

  • Non-Covered Procedures

    The policyholder receives the explanation of benefits (EOBs) in the mail from their insurance carrier; they explain what procedures were performed on that date of service. These are procedures that your insurance company will not cover and pay. The EOBs will determine what the policyholder is responsible for, if the insurance does not cover procedures. Self-pay patients are responsible for all charges and should be paid at time of service. If this is not possible, you must see the billing department to discuss a financial agreement.

  • Co-insurance

    Co-insurance is also an out-of-pocket expense. Co-insurance is based on the member’s contract with their insurance carrier. Some insurance carriers pay at a percentage rate of 80/20 while others may pay at a percentage rate of 70/30; the rates vary. Depending on the percentage rate, your insurance will pay that percent, leaving the balance to the member. If the secondary insurance does not cover, then the policyholder would be responsible.

Child drawing a picture with crayons

We expect payment of your co-pay at the time of service. For your convenience we accept cash, check, and the following credit cards:

Mastercard visa and discover logos on a white background

Monthly payment arrangements can be set up, please contact Billing at 718.982.6800 or via email at billing@gpmpediatrics.com. You can also choose to pay your bill online.

  • Most Union Plans are accepted
  • We do not participate with Medicaid directly.
  • We DO NOT accept EmblemHealth Select Care Network Plans. This means NO GHI or HIP that say SelectCare on them.
  • PANELS CLOSED: Patients currently on this plan will continue to be seen by our practice; however no additional patients can go onto these insurances, please contact our office for more information.
  • We do our best to stay on top of each patient’s insurance policy; however, it is your responsibility to notify us of any changes in your insurance to ensure that the claim is sent to the correct insurance plan and that you are not held responsible for the charges.
  • On occasion, we may ask you to become involved in assisting us with contacting your insurance company to resolve a claim. Also, it is your responsibility to understand the specific coverage benefits and limitations your plan provides.
  • Please note that if any members of your family are admitted to the hospital, please follow your insurance company requirements to reduce your risk of payment problems.


Important Note for PARENTS: Please note that it is extremely important you add your newborn to your insurance policy once your baby is born. Most insurance plans have a 30-day grace period. Once the grace period has expired and the baby is not added on the insurance policy, the parents will be responsible for charges endured. Please remember to bring your insurance card, co-pay, and patient forms to your first visit. 


Two hand drawn stars on a white background.

Important Information

A group of green triangles on a white background.

Participating Insurance Plans

  • 1199 National Benefit Fund
  • Aetna – HMO & PPO
  • Cigna
  • Emblem Health/GHI
  • Emblem Health/HIP
  • Empire BC/BS – HMO & PPO
  • Empire BC/BS Health Plus Medicaid Funded & Child Health Plus (PANELS CLOSED*)
  • Empire BC/BS Health Plus Medicaid Funded & Child Health Plus (PANELS CLOSED*)First Health
  • Horizon of NJ PPO (Blue card ONLY)
  • Humana/Choicecare Network
  • Magnacare
  • Multiplan
  • NY Government Plan (United HC Empire Plan)
  • NY Government Plan (United HC Empire Plan)
  • Oxford Liberty & Freedom (Excluding Metroplan)
  • Tricare
  • United Healthcare
  • US Family Healthplan
  • Most Union Plans Accepted


For more details or information regarding insurance coverage, please contact our offices.

Share by: