Aetna

An OB-GYN in Miami who takes Aetna.

Vireo is contracted with Aetna for Choice POS II, Open Access, Managed Choice. The office verifies your specific benefits before the first visit, so what you owe is known in advance rather than billed afterwards.

The detail

What being in network with Aetna means here

  • Products we are contracted with: Choice POS II, Open Access, Managed Choice.
  • Open Access products do not require a referral. Managed Choice does.
  • Benefits are verified before your first visit and your expected share is quoted to you in advance.
  • If your product turns out not to be covered, we tell you before you come rather than billing you after.

What is covered

Where the plan ends and the bill starts

Products we are contracted with choice POS II, Open Access, Managed Choice.

Office visits

In-office ultrasound, IUD and implant placement, endometrial biopsy and office hysteroscopy are billed to the plan under the visit.

Obstetric care is usually billed as a global package after delivery; the hospital bills its facility fee separately under the same plan.

Surgery carries a professional fee from us and a facility fee from the hospital or surgical centre. Both go to your plan; both have their own share.

Anything not covered is quoted to you before it happens

Not billed afterwards.

Referrals and authorisation

What has to be in place before the visit

  • Open Access products do not require a referral. Managed Choice does, and the referral must be on file before the visit rather than obtained afterwards.
  • Prior authorisation is required for most surgery and some imaging. The office obtains it; you do not chase it.
  • Benefits are verified before your first visit and your expected share is quoted in advance.
  • Aetna’s behavioural and maternity benefits sometimes sit under separate administration — the office checks both when verifying.

Aetna questions

How do I confirm my specific plan?
Call the office with your Aetna member ID. We check the product, not just the insurer, because that is where coverage actually differs.
Does this cover deliveries?
Our professional fee for prenatal care and delivery is billed through your plan. The hospital bills its own facility fee separately, under the same plan but on a separate claim.
What if I change plans mid-pregnancy?
Tell the office as soon as you know. We re-verify and, if we are out of network on the new plan, we say so immediately rather than at the next visit.
What if my plan changes mid-pregnancy?
Tell the office as soon as you know. We re-verify immediately and, if we are out of network on the new plan, we say so at that point rather than at the next visit.
Can you tell me what I will owe before I come?
For a first visit, yes — once we have verified your benefits we quote the expected share. For surgery, the estimate comes after prior authorisation, because that is when the plan states its own terms.
What if the plan denies something?
We tell you the reason, and we appeal where there are grounds. An appeal is part of the service rather than something you are left to do.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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