Board-Certified Pediatricians Caring for Newborns to Adolescents

Sunshine Pediatrics is contracted with the following insurance companies and/or physician networks. A physician network is a group of physicians that a smaller insurance company may “rent” to provide care for their members. This means many smaller insurance companies may not be on this list, but the network they use might be. Always check your card to see which network they use. While we do file claims to your primary insurance, we do not file claims to secondary insurance plans. We will, however, provide you with the information necessary to file your own claims.

This list of insurance and networks can change at any time. We recommend that you call our billing department if you do not see your plan on this list: 803-980-7337 option 4.

Please keep in mind:

In order for us to file your medical claim accurately and within the timely filing requirements of your insurance plan, we request that you bring your insurance card at every visit. It is your responsibility to provide us with the most recent insurance card. If your insurance has changed, and you do not have the new insurance information, you will be asked to pay in full at the time of visit. Once the information is received and the insurance has paid the claim in full, your payment will be refunded.

According to our contracts with the insurance companies and networks, we are required to collect your copay on the date of service. There is a $10 late fee for all copays and co-insurances not paid within 24 hours of the date of service. Deductible responsibilities are also expected to be paid at the time of service. We will accept a $50 deposit toward your deductible, but if any balance is not paid within 30 days of being invoiced, the full deductible balance on future appointments will be due at the time of service. See our Financial Policies for more information.

We will make every effort to determine the benefits of your insurance plan prior to your visit, but it is up to you to know what your plan covers. We cannot guarantee that benefit information given to us is correct, and so the ultimate financial responsibility for any medical treatment is yours.

We recommend that you call your plan before your visit to find out what your benefits cover. You should ask specifically about wellness benefits, sick benefits, and immunization coverage. You should also ask if any deductibles, copays, and/or coinsurances apply to each of these benefit categories and see if there is a cap or maximum benefit amount that applies to each of these as well. For a glossary of commonly used insurance terms, please see our Financial Policies.

• Absolute Total Care

• Aetna

• Ambetter

• BeechStreet network

• Blue Cross Blue Shield

• BlueChoice Health Plan

• BlueChoice Medicaid (Healthy Blue)

• Cigna

• CoreSource (uses multiple networks)

• Coventry HealthCare

• First Health/Coventry

• Humana and Humana Medicaid

• MedCost

• Medicaid (SC only)

• Molina and Molina Marketplace

• MultiPlan network

• PAI - Planned Administrators, Inc.

• PHCS (now MultiPlan network)

• Premier Health Plan (now SuperMed)

• SuperMed network

• United Healthcare

• United Medical Resources

Board Certification is a process where a special independent organization provides credentials to a provider, signifying a high level of professional competency. Certifications are usually time-limited, meaning that the medical professional will have to re-certify after a given time period. The recertification usually involves comprehensive testing, among other things, and demonstrates their commitment to professionalism, lifelong learning and self-evaluation.