Insurance and Billing
Clear answers on coverage and cost
How insurance, out-of-network reimbursement, and concierge fees work at PediGut Health.
Do you accept insurance?
PediGut Health operates as a concierge, out-of-network pediatric GI practice. We do not bill insurance directly, but we provide detailed superbills that families can submit to their plan for potential out-of-network reimbursement.
Will my insurance cover the visit?
Many PPO plans reimburse a portion of out-of-network specialist visits once your deductible is met. Coverage varies, so we recommend calling your insurer's member services line and asking about out-of-network pediatric gastroenterology benefits.
What about labs, imaging, and procedures?
Labs, imaging, endoscopy, and pathology are typically billed by the facility or lab directly to your insurance as in-network services. Dr. Mendez orders these at facilities that participate with most major plans.
Do you offer payment plans?
Yes. For the concierge membership and individual visits, we offer transparent pricing and flexible options. Reach out and our team will walk you through it.
Can I use HSA or FSA funds?
Yes. Concierge medical fees, visits, and procedures are typically eligible HSA and FSA expenses.
Still have questions?
Our team is happy to walk through pricing, membership, and how out-of-network reimbursement might work for your family.