Payment for Services

Clinic services will be provided regardless of your ability to pay. Funding for clinic operation is provided by United Way of Erie & Crawford counties. However we are required to bill insurance or other sources for reimbursement. Remember our staff volunteers without pay. So all monies collected are used to continue clinic operation. Your assistance is needed.

Medical Assistance
You must bring your Registration Card or PA Access Card to the clinic.

HMO/Insurance
If you have an HMO: Highmark, Keystone, Select Blue, or other, you must contact you primary care physician and request that a Cleft Palate Clinic referral be submitted to our office before the scheduled clinic visit. For Gateway or Med Plus you must request an "out of network" referral from you Primary Care Physician. For Health America, you do not need a referral.

If you have other Insurance: bring your insurance cards to clinic. We will submit your clinic services statement to your insurance carrier. Monies paid directly to you by your insurance company for billed clinic services for your child must be sent to the Cleft Palate Clinic office. We will notify your insurance carrier if such monies are not forwarded to us.

PA Department of Health
Some funding may be available from the Department of Health. To determine your financial eligibility you must complete the PA Socio Financial Form. You may obtain this form and information by calling
1-800-852-4453 or 717-787-2020 or write directly to:

PA Department of Health
Div. Special Health Care Program
Rm 724 Health and Welfare Bldg
PO Box 90
Harrisburg, PA 17108