Insurance at AllergyMD

AllergyMD is in-network with most major insurance plans serving Decatur and Atlanta.

Most patients can use their existing insurance for visits at AllergyMD. We accept most commercial PPO and HMO plans, Medicare and Medicare Advantage, and Tricare plans.

If you don't see your plan listed below, call us at 678-632-2360.

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Accepted plans

Commercial plans

  • Aetna

  • Blue Cross Blue Shield (BCBS)

  • Cigna

  • United Healthcare

  • Ambetter

  • GEHA

  • Kaiser Permanente Dual Choice PPO †

  • Oscar Health Plan

  • UMR

  • And many others

Medicare

  • Medicare Part B

  • Aetna Medicare Advantage

  • Blue Cross Blue Shield Medicare Advantage

  • United Healthcare Medicare Advantage

Tricare

  • Tricare East

  • Tricare Select

  • Tricare Prime *

  • Tricare Active Duty *

Footnotes:

* Plans marked with an asterisk require a referral from your primary care provider before your visit. Our team will help you navigate this when you book.

Kaiser Permanente Dual Choice PPO patients: your insurance card displays the MultiPlan PHCS network logo.

Don't see your carrier?
Some smaller plans are accessed through network partnerships listed above. Call us at 678-632-2360 — we'll verify your coverage before your visit.

Verifying your coverage before your visit

AllergyMD will try to review your insurance information before your visit, but it's ultimately your responsibility to confirm coverage with your insurance provider before your first appointment. Here's how to verify your coverage and what to ask.

What you'll need when you call your insurance

  • Your insurance card (member services phone number is on the back)

  • Name and date of birth of the policyholder

  • Your physician: Dr. Tricia Lee

  • Office address: 755 Commerce Drive, Suite 800, Decatur, GA 30030

  • Office EIN / Tax ID: 93-1603027

When you call your insurance, ask:

  1. Is AllergyMD (Dr. Tricia Lee) in-network with my plan?

  2. Do I need a referral from another physician?

  3. What is my copay for a specialist visit?

  4. Are these services covered? If they are covered, is it subject to copay, deductible, and/or co-insurance? [definitions below]

  • Office visit with an allergy specialist (CPT codes: 99203, 99204)

  • Allergy testing in the office (CPT codes: 95004, 95024, 95044)

  • Breathing tests in the office (CPT codes: 94010, 94060)

Note: If you have a deductible, you may want to ask for contracted prices for these services so you can estimate your out-of-pocket cost.

Understanding insurance terminology

Copay: A fixed amount you pay for a covered service, regardless of the total cost. For example, you might have a $30 copay for each specialist visit. Specialist copays are often higher than primary care copays.

Deductible: The amount you pay out of pocket for covered services before your insurance starts paying. For example, with a $1,000 deductible, you pay the first $1,000 of covered services before insurance kicks in.

Coinsurance: A percentage of the cost of a covered service that you pay after meeting your deductible. For example, if your coinsurance is 20%, you'll pay 20% of the cost and your insurance pays the rest.

Out-of-pocket maximum: The most you'll pay for covered services in a single year. Once you reach this maximum, your insurance pays 100% of covered services for the rest of the year.

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Common questions

Do I need a referral to be seen at AllergyMD?

Most patients can book directly without a referral. A few insurance plans do require one — those are marked with an asterisk on our list above. Our team will help you navigate the referral process when you book.

Do you accept Medicaid?

We accept Medicaid of GA (DCH only). We do not currently accept Amerigroup, CareSource, Peach State, or other Medicaid Managed Care plans.

Do you accept Medicare?

Yes — we accept Medicare Part B and most Medicare Advantage plans, including Aetna, Blue Cross Blue Shield, and United Healthcare Medicare Advantage.

What if my insurance isn't listed?

Call our office at 678-632-2360. We'll verify your coverage before your visit. We're regularly adding new insurance contracts, so even if your plan isn't listed today, we may still be able to see you.

Cost transparency

AllergyMD believes in transparent pricing. If you'd like an estimate of out-of-pocket costs for your visit, please call us at 678-632-2360 to help you understand your benefits and any expected costs before you come in.

READY TO GET STARTED?

Schedule an appointment with Dr. Lee or call our office for questions about your care.