For your convenience, Orange Coast Women’s Medical Group accepts most major insurance plans including PPO, POS, EPO, Medicare, Tricare, and some Covered California Exchange plans. We accept all major HMO plans through Monarch HealthCare, Hoag Medical Group and Hoag Physician Partners. Please note: Your primary care physician must be affiliated with either of these groups, please refer to your insurance card.
We accept cash, personal checks, and all major credit cards (except AMEX) as well as “Flex and HSA” cards.
Please note: At the time of your visit you will be responsible to pay your specialist co-pay, coinsurance, past due balances and/or any unmet deductible amounts at the time of service. We are also happy to file your claim for you, but the balance is your responsibility if your insurance company or plan does not pay after 30 days. Any amount not covered by your insurance policy is due immediately after you receive your first invoice from us.
Medicare: We will bill your secondary insurance provider directly. You will be asked to sign an Advanced Beneficiary Notice for service not covered under Medicare.
Please make sure to verify that your insurance is “in-network”, Tax ID # 330676831. “In Network” vs. “Out of Network” – means your insurance coverage and benefits are a contract between you and your insurance company and therefore all disputes must be handled between you and your insurer. OCWMG is contracted with multiple insurers to accept assignments of benefits. If you have insurance coverage under a plan with which we do not have a contract, you will be treated as a self-pay patient. We encourage that you become familiar with your insurance plan benefits as benefits may change.
For all visits, we bill your insurance provider directly. If your insurance has changed please notify or provide us with your current information prior to your scheduled appointment. Please make sure to bring your insurance card with you to your appointment; we will need to take a copy of the new information printed on your insurance card.
In regards to new pregnancy patients that have HMO insurance with Monarch, you are able to self-refer. You do not need a primary care physician referral.
At OCWMG we are committed to providing excellent health care for everyone. Financial hardships should never stop you from getting the medical care you need. Please consult our billing department.
Below are the following insurance company’s OCWMG accepts. If you do not see your insurance plan listed below, OCWMG may still be a participant in your plan. Please contact the customer service number locate on the back of your insurance card or please reach out to our billing department.
Contact: 949-829-5500 (option 4) or message us through the patient portal.
We accept the following insurance plans:
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HMO PLANS
- Blue Cross Anthem Priority Select HMO – Medical Groups: Hoag Medical Group and Hoag Physicians Partner (Starting 1/1/22)
- Hoag Medical Group
- Hoag Physician Partners
- Monarch Healthcare Medical Group
- Other
- Caloptima One Care (needs to be assigned to Monarch HealthCare Medical Group; OneCare is the only CalOptima plan our office is contracted with)
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COVERED CALIFORNIA (EXCHANGE)
- Blue Shield IFP Exclusive PPO
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PPO PLANS
- Aetna
- Anthem Blue Cross
- Blue Shield (including EPO)
- Blue Shield – Tandem
- Cigna/GreatWest
- First Health
- GEHA
- Medicare
- Kaiser POS & Kaiser PPO (Surgery & Birthing Facilities not eligible)
- Medi-Share
- Multiplan
- Tricare Standard West
- Tricare Prime West
- UMR
- United Healthcare
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Non-Participating Insurance Carriers:
- Aetna Premier Network (some employers groups we are, check view details)
- Aetna Apria Healthcare (Aetna Premier Care Network)
- Aetna One Care Premier Network
- Aetna Premier Care Network Plus (OPEN ACCESS SELECT/EPO) with Any Employer Group
- Aetna Whole Health (Southern California) only Monarch HMO we take
- AARP Medicare Advantage UHC-UCARD
- Meritain Aetna Premier Signature
- AIM “Blue Cross”
- AIM “MCAP(MEDI-CAL ACCESS PROGRAM)”
- Blue Cross with AHMC Healthcare Inc. /Select Advantage EPO
- Blue Cross AIM
- Blue Cross PPO (MEMORICAL CARE EMPLOYEES) We are considered Tier 2 providers, which means patient can be seen by our office, they just have a higher out of pocket
- Blue Cross-Medicare Advantage PPO -MediBlue Access
- Blue Cross Vivity PPO
- Blue Cross Pathway X EPO (Covered CA Plan)
- Blue Cross Blue Shield – Memorial Health Alliance (Boeing)
- Blue Shield IFP Exclusive EPO (Covered CA Plan)
- Cal Optima (Healthy Families)
- Cigna Select (please contact Billing dept for clarification)
- CARE 1ST Health Plan HMO–Blue Shield
- Greater Newport Physicians Medical Group IPA (HMO) – effective 01/01/2020
- Health Net PPO Enhanced Care Network – Covered CA Individual plan
- ANY/ALL HEALTHNET PPO PLANS – EFF 12.1.2023 WILL BE PROVIDERS
- HEALTHNET-AMBETTER PPO/HMO- NOT PROVIDERS
- HEALTHSCOPE
- Humana National POS- Open Access
- Any Humana PPO
- Humana Choice Care Network EPO
- Kaiser HMO
- MCAP(MEDI-CAL ACCESS PROGRAM) – AIM
- Medi-Cal
- Memorial Care Medical Group IPA (HMO) – effective 01/01/2020
- Memorial Care Health Alliance-BCBS /Boeing – Preferred partnership ACO
- Monarch Healthcare – Molina Healthcare – effective 02/01/2020
- Monarch-United Healthcare HMO with Long beach/Los Alamitos Network
- Oscar Select effective 01/01/2020-OCWMG
- OSCAR SELECT – DR JAMES CONTRACT TERMS 12/31/2020
- Quantum care (Employer – Kindercare)
- Sharp Medical Group
- United Healthcare Core
- United Healthcare Empire Plan
- United Healthcare Navigate
- United Healthcare Liberty Network
Last updated: 01/15/2024
*Here at OCWMG we do not accept any insurance with international claims addresses.
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Maternity Benefits
What is a Cost-Share?
The portion of your benefits that is not covered by your insurance.
This means that you are responsible for paying for these benefits out of your own pocket. The term cost-share may include your deductible (the amount owed before your insurance will cover any benefit), coinsurance (a percentage of the cost of any medical service that is your responsibility), and copayments. Monthly insurance premiums, balance billing amounts for non-network providers, or the cost of non-covered services are outside of a cost-share.
Deductibles and coinsurance can add up to a significant amount. We have created a payment plan based on our contracted insurance amount for global maternity benefits. This payment plan includes your portion of the coinsurance and possibly a portion of your deductible. The payment plan is designed to help reduce the amount of monies owed for your pregnancy care and to avoid a large bill after your delivery. Please note that the payment plan does not cover your inpatient hospital charges. The hospital’s bill is a separate entity.
What are Global Maternity Benefits?
Global maternity benefits are a one-time bill that covers your routine antepartum/prenatal office visits, your provider’s fee for the delivery, and routine postpartum visits. This bill is submitted to your insurance after your delivery.
Services not part of Global Maternity Care and which are billed as separate services include:
- Ultrasound and office visit confirming your pregnancy.
- Pregnancy complications resulting in more than the usual number of prenatal/postpartum office visits. Routine/uncomplicated pregnancies typically have 13 visits.
- A visit with an OB/GYN for symptoms/diagnoses which are unrelated to pregnancy.
- Laboratory tests (excluding dipstick urinalysis).
- All ultrasounds.
- Any services performed by a perinatologist (for example, amniocentesis, cordocentesis, chorionic villus sampling).
- Fetal monitoring, aka fetal non-stress test.
- Management of surgical complications that may occur during pregnancy.
Online Bill Pay
Please login to your patient portal and select Billing.