What if I have anout-of-network plan?

Children's Mercy recommends following the steps outlined below to ensure you can make the most of your insurance benefits and help lower your financial out-of-pocket costs.


Step 1: Review the List of Insurance Plans

Take a moment to review the list of plans that have chosen to include Children’s Mercy in their network.

Step 2: Call Your Insurance

If you do not see your insurance listed, call your insurance and ask what providers are available in your coverage network.

Step 3: Seek care in your coverage network

To avoid higher out-of-pocket costs for your child's services, it is best to seek treatment with the health care providers approved by your insurance plan or specific coverage network.

Step 4: Request an Exception for Children's Mercy When Services Aren't Available in Your Coverage Network

If there are not any providers that can perform the service within your coverage network, please ask your insurance how to request an approval for your child to receive services with each individual out of network provider. Once they have provided you with the approval please request a call reference number for the call. Next fill out the Out of Network Request form below, where you will give the call reference number for each exception you have received. Once you have completed and submitted the form, the Children's Mercy Financial Clearance team will review and work with your insurance to attempt to seek authorization and any single case agreements that are necessary for your child to be seen here.

Out-Of-Network Exception Form


To obtain an out-of-pocket cost estimate for services at Children's Mercy prior to scheduling or if you believe you may already have an exception in place with your insurance, please email the Financial Clearance team at NarrowNetwork@cmh.edu for more information.