KATHERINE J DELONG-HECKER M.D.
Accepted Insurance for NPI 1477870921
Pediatrics in River Falls, WI

Q: What managed care network types are accepted by this provider?

KATHERINE J DELONG-HECKER M.D. is enrolled across the following managed care network types: EPO, HMO, POS, PPO. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

NPI Status: Active since April 23, 2010

Contact Information

1617 E DIVISION ST
RIVER FALLS, WI
ZIP 54022
Phone: (715) 307-6600
Fax: (715) 307-6601

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with KATHERINE J DELONG-HECKER M.D., a practicing pediatrics professional in River Falls, WI. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 46 individual coverage options managed by medical networks, including networks like Anthem Blue Cross and Blue Shield, HealthPartners, and Medica. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Fitler by Network Type

Anthem Blue Cross and Blue Shield

Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560003

Anthem Bronze Preferred/Broad HSA (+ Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560002

Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560006

Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560005

Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560008

Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560001

Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560009

Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560004

Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560007

HealthPartners

Atlas $1,300 Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130020

Atlas $2,000 Standard Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130040

Atlas $3,050 Plus Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130021

Atlas $3,800 HSA Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130026

Atlas $6,000 Standard Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130041

Atlas $6,800 Plus Bronze HSA

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130023

Atlas $7,500 Standard Bronze HSA

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130042

Atlas $8,400 HSA Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130027

Oak $1,300 Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130001

Oak $2,000 Standard Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130011

Medica

Engage by Medica Bronze HSA

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050011

Engage by Medica Bronze Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050029

Engage by Medica Expanded Bronze Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050073

Engage by Medica Gold $0 Copay PCP Visits

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050074

Engage by Medica Gold Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050076

Engage by Medica Gold Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050055

Engage by Medica Silver $0 Copay PCP Visits

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050075

Engage by Medica Silver Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050027

Engage by Medica Silver Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0050057

Medica Individual Choice Bronze $0 Copay PCP Visits

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130041

Medica Individual Choice Bronze HSA

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040011

Medica Individual Choice Bronze Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040029

Medica Individual Choice Bronze Share

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130029

Medica Individual Choice Expanded Bronze Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040073

Medica Individual Choice Expanded Bronze Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130073

Medica Individual Choice Gold $0 Copay PCP Visits

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040074

Medica Individual Choice Gold $0 Copay PCP Visits

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130045

Medica Individual Choice Gold Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040076

Medica Individual Choice Gold Share

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130074

Medica Individual Choice Gold Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040055

Medica Individual Choice Gold Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130055

Medica Individual Choice Silver $0 Copay PCP Visits

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040075

Medica Individual Choice Silver $0 Copay PCP Visits

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130047

Medica Individual Choice Silver Share

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040027

Medica Individual Choice Silver Share

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130076

Medica Individual Choice Silver Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040057

Medica Individual Choice Silver Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130057

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does KATHERINE J DELONG-HECKER M.D. accept?

This provider accepts health insurance plans managed by the following insurance companies: Anthem Blue Cross and Blue Shield, HealthPartners, Medica. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.

What managed care network types are accepted by this provider?

KATHERINE J DELONG-HECKER M.D. is enrolled across the following managed care network types: EPO, HMO, POS, PPO.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.
EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.