Insurance Questions, Answered

Which Insurance Plans Does MomDoc Accept?

MomDoc accepts most major commercial insurance plans, AHCCCS (Arizona Medicaid) plans, Medicare, Tricare, and a wide range of contracted networks through Multiplan. We also accept Federal Emergency Services (FES) for maternity care.

For a full list of accepted plans, visit our Insurance & Payment page. If you do not see your plan listed, call us at 480-821-3601 for a courtesy verification. We accept hundreds of plans, and our list changes periodically as contracts are updated.

Am I In-Network or Out-of-Network?

Whether you are in-network depends on your specific plan, not just your insurance company. For example, we may be in-network for one United Healthcare plan but not another.

The fastest way to confirm your in-network status is to call us at 480-821-3601 before your appointment. Our team will run a courtesy benefits check and let you know what your plan covers.

What if I am out-of-network? You can still be seen at MomDoc. Your out-of-network benefits may cover a portion of the visit, and you would be responsible for the difference. We are happy to provide a cost estimate before your appointment so there are no surprises.

Do I Need a Referral?

Most PPO and self-funded plans do not require a referral to see a specialist like an OB/GYN. However, some HMO and managed care plans do require a written referral from your primary care physician.

How to check: Look at your insurance card. If it says "HMO" or "Managed Care," contact your primary care doctor's office to request a referral to MomDoc before scheduling.

If you arrive without a required referral, we can still see you, but your insurance may not cover the visit. Our team will let you know at check-in.

What Is Prior Authorization?

Prior authorization is when your insurance company requires advance approval before covering certain procedures or tests. Common examples include:

• Imaging such as ultrasounds or MRIs (beyond standard prenatal scans)
• Surgical procedures like hysterectomy or laparoscopy
• Specialty medications

Our clinical team handles prior authorizations for you. When your provider orders a procedure that requires approval, we submit the paperwork to your insurance company and follow up until we have an answer. You do not need to call your insurance company yourself for these.

How long does it take? Most prior authorizations are approved within 3 to 5 business days. Urgent requests can be expedited within 24 to 72 hours.

How Does Pregnancy Billing Work?

Maternity care uses a "Global Fee" model. Instead of billing for each prenatal visit individually, most insurance plans bundle all your routine prenatal care, your delivery, and your postpartum checkup into one package.

What that means for you:

• You likely will not see claims filed after every single prenatal visit
• Your insurance applies your deductible and coinsurance to the global package
• We confirm your maternity benefits early in your pregnancy so you know what to expect

Lab work, ultrasounds, and hospital facility charges are billed separately from the global fee. You may receive separate bills from the lab (such as Sonora Quest or LabCorp) and from the hospital where you deliver.

Why Did I Get a Bill for My "Free" Annual Exam?

Your insurance covers preventive care (like a Well Woman exam) at 100% with no copay. However, if you discuss a specific medical concern during that same visit, such as irregular bleeding, pelvic pain, or a new symptom, insurance rules require a diagnostic code in addition to the preventive code.

The diagnostic portion may trigger a copay or deductible charge. We are happy to address both preventive and diagnostic concerns in one convenient appointment, but your insurance may bill the problem-focused portion separately.

Tip: If you want to avoid a surprise bill, let your provider know at the start of your visit that you would like to keep it strictly preventive. You can always schedule a separate follow-up for other concerns.

What If I Do Not Have Insurance?

MomDoc believes every woman deserves access to quality healthcare. We offer several options for uninsured and underinsured patients:

• Good Faith Estimates: Before scheduling non-emergency services, ask our team for a written estimate of expected charges. You have the legal right to receive one.
• Sliding Fee Scale: Based on Federal Poverty Guidelines, family size, and income. Proof of income is required.
• Self-Pay Rates: We offer competitive self-pay pricing. Visit our Payment Options page for details.
• AHCCCS Enrollment Help: If you may qualify for Arizona Medicaid, our team can point you toward enrollment resources.

How Can I Pay My Bill?

We accept cash, check, Visa, Mastercard, American Express, Discover, HSA cards, and FSA cards. You can pay in person at any MomDoc location or by phone.

For billing questions or to set up a payment plan, call us at 480-963-4083 and ask for the billing department.