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Patient Resources

Insurance & Billing

We accept most major insurance plans and verify your benefits before scheduling so you know your costs upfront.

Accepted Insurance Plans

As part of the Northside Hospital network, Gwinnett Robotic & Hernia Surgery accepts most major commercial, Medicare, Medicaid, and workers’ compensation insurance plans. The plans listed below are accepted at Northside Hospital facilities where Dr. Kakarla operates.

Commercial Plans

  • Aetna
  • Ambetter
  • Anthem Blue Cross Blue Shield (including Pathway plans)
  • CareSource
  • Cigna (including Cigna + Oscar Open Access)
  • Coventry National / First Health
  • Health One Alliance
  • Humana
  • Kaiser (including Kaiser-Tricare Prime Option)
  • Lifewell
  • Multiplan / PHCS
  • Northside Health Network
  • Novanet
  • Oscar Health
  • Tricare
  • UnitedHealthcare
  • VA Community Care Network (VA CCN)

Medicare Advantage Plans

  • Aetna · Anthem Blue Cross Blue Shield · CareSource · Cigna Medicare Advantage · Clover · Coventry Advantra · Eon · Humana · Kaiser · Peach State (Allwell) · Sonder · UnitedHealthcare · Wellcare

Original Medicare (Part A and Part B) is also accepted.

Medicaid Managed Care

  • Amerigroup · CareSource · Peach State (Centene) · WellCare

Workers’ Compensation

  • Aetna · Coventry · Corvel Healthcare · Heritage Summit Healthcare/Synergy · Identity MCO · Multiplan · Spreemo

This list is updated periodically but Northside Hospital does not guarantee participation with all plan products. New insurance plans are offered constantly. If you do not see your plan listed, please call our office at (770) 962-9977 — we may still participate with your network. Always verify coverage with your insurance provider before your visit.

View the full, current list on Northside Hospital’s website →

How Insurance Verification Works

1

You call to schedule

Call (770) 962-9977 or request a callback. Our scheduling team collects your insurance information.

2

We verify your benefits

Before your appointment, our billing team contacts your insurance to verify your coverage, deductible, copay, and coinsurance for the recommended procedure.

3

You know your costs upfront

We share your estimated out-of-pocket cost before you commit to surgery. No surprises. All costs are subject to your plan rules and patient responsibility (deductible, copay, coinsurance).

Do I Need a Referral?

Most patients do not need a referral. You can call our office directly to schedule an appointment with Dr. Kakarla. The only exception is if your specific insurance plan requires a referral from your primary care physician before seeing a specialist — some HMO plans have this requirement. If you are unsure, call your insurance company or ask our scheduling team and we will help you figure it out.

Billing Questions

Understanding your bills

After surgery, you may receive separate bills from multiple providers. This is standard and not an error:

  • Surgeon’s fee — from our office for Dr. Kakarla’s surgical services
  • Facility fee — from the hospital or surgery center where the procedure was performed (Northside Hospital Gwinnett, Northside Outpatient Surgery Center, or Gwinnett Surgery Center)
  • Anesthesia fee — from the anesthesia group that provided your anesthesia
  • Pathology / lab fee — if specimens or blood work were processed

Each provider bills your insurance separately. Your out-of-pocket responsibility for each depends on your plan’s deductible, copay, and coinsurance structure. Payment methods accepted at Northside Hospital include Visa, MasterCard, American Express, Discover, checks, and cash.

Financial Assistance

Northside Hospital offers a Financial Assistance Program for uninsured, underinsured, and medically indigent patients who need help paying for medically necessary care.

  • Patients with annual household income at or below 300% of the Federal Poverty Level may qualify to receive a full discount on care
  • Income, assets, debt, and expenses are evaluated for eligibility
  • Insured patients may also apply if they have a remaining balance after all insurance payments are exhausted
  • Payment plans are available for patients who cannot pay in full

The Financial Assistance Application is available in English, Spanish, Korean, and Vietnamese. Download the application or request a copy from Northside’s Financial Counseling office.

Northside Hospital Financial Assistance Program →

Northside Hospital Billing Customer Service

For questions about hospital or facility bills (not Dr. Kakarla’s surgical fee), contact Northside Hospital’s billing department:

For questions about Dr. Kakarla’s surgical fee, call our office at (770) 962-9977.

What if I don’t have insurance?

Please call our office to discuss your situation. You may qualify for Northside Hospital’s Financial Assistance Program, which provides discounted or free care for patients who meet income and eligibility guidelines. Payment plans are also available. A deposit may be required for non-emergent services, but emergency care is never delayed for financial reasons.

What is a deductible?

A deductible is the amount you pay out of pocket before your insurance begins to cover costs. For example, if your plan has a $2,000 deductible and you have not met it yet, you will pay the first $2,000 of covered services before insurance begins paying its portion.

What is the difference between copay and coinsurance?

A copay is a fixed dollar amount you pay for a service (for example, $40 for a specialist visit). Coinsurance is a percentage you pay after meeting your deductible (for example, you pay 20% and insurance pays 80%). Your plan may use one or both.

Will my surgery be covered?

Most surgical procedures Dr. Kakarla performs are medically necessary and covered by insurance. We verify your specific coverage and get any required pre-authorization before scheduling. Cosmetic procedures are not covered by insurance.

I received a bill I have questions about

Call our office at (770) 962-9977 and ask to speak with our billing department. We are happy to explain any charges and help resolve questions about your bills.

Gwinnett Robotic & Hernia Surgery 631 Professional Drive, Suite 300, Lawrenceville, GA 30046
(770) 962-9977 · Mon–Thu 7 am–4:30 pm, Fri 7–11 am

Questions About Your Insurance?

Our team verifies your benefits before your first visit. Call us and we will help.

Your Rights Under the No Surprises Act

The No Surprises Act (effective January 2022) protects you from unexpected out-of-network medical bills. Here’s what this means for your surgery:

Our practice participates with most major insurance plans, and our surgical facilities are in-network with the same plans. We verify your benefits before scheduling so you know your estimated out-of-pocket cost in advance. Questions about any charges? Call our billing team at (770) 962-9977.

Surgery Center vs. Hospital — Cost Savings

Many outpatient procedures can be performed at Gwinnett Surgery Center, which is significantly more affordable than hospital-based surgery.

Dr. Kakarla will recommend the appropriate facility based on your procedure complexity and medical history. Not all procedures are suitable for the surgery center — more complex operations are performed at Northside Hospital for safety.