This is a professional office that renders quality care to patients. Our duty is to preserve the dignity and confidentiality of our patients while receiving appropriate payment for the medical care provided.
As a primary care practice, we must collect known patient financial obligations for services provided. This includes insurance plan required deductibles, co-pays, and co-insurance amounts. Patients must pay deductibles before any surgical procedure is performed and at the time that office services are rendered.
- 1. Co-pay- the co-pay is an amount you pay each time you go to the doctor, fill a prescription, or receive a covered health service.
- 2. Co-insurance- this is the percentage of the cost for health care services that you must pay after you’ve met your deductible. Most plans will pay a percentage of the remaining cost for covered health services and require you to pay the rest. The co-insurance will vary by plan. For instance, some plans may pay 80 percent of the cost, leaving you to pay 20 percent, while others may pay 70 percent, leaving you to pay 30 percent. As with deductibles, the higher the amount you pay in coinsurance, the lower your premium will be.
- 3. Deductibles- this is the amount that you must pay for covered medical services out of your own pocket before your plan will begin to pay. If you have a family plan, the deductible may apply to your entire family, or each individual may have a separate deductible. You’ll have to meet your deductible each year. Many insurance companies offer high deductible options for plans. In general, the higher your deductible, the lower your premium.
We will bill your visit to your insurance plan if you provide an updated insurance card at each visit. Please note that the insurance coverage is between you and your insurance carrier; we are happy to file the claim, but the balance is your responsibility to pay if your plan does not pay after 45 days. Amounts not covered by your insurance are due immediately after you receive your first statement from us.
The following can be some of the reasons for insurance not issuing payment:
- 1. When claim is denied due to benefit limitations
- 2. Services are not covered under plan
- 3. Additional information may be needed from patient/member regarding pre-existing condition
- 4. Denied claim due to patient ineligibility
- 5. Member policy number has changed
- 6. Employer/ group terminated
- 7. Yearly deductible not met
Insurances We Accept:
- Aetna - PPO & Medicare Advantage
- Allegian - PPO & Medicare Advantage
- Assured Benefits
- BCBS - PPO & HMO & Medicare Advantage
- Boon Chapman
- Care Improvement Plus
- Cigna - PPO & GWH & HMO
- First Health
- Frates Benefits Admin /Sharyland ISD
- Health Choice
- HealthSmart - PPO
- Humana - PPO & Medicare Advantage
- Mail Handlers Benefit Plan
- Medicaid - HMOs (Driscoll, Molina, Superior, UHC)
- Medicare - Novitas
- Meritain Health - MRMC Hospital
- Molina - Medicare options
- PGBA Tricare / WPS
- PHCS MultiPlan
- TML - Texas Municipal League TML
- TWHP - Texas Women's Health Program
- United Health Care
Please contact your Insurance regarding your plan prior to calling our office for questions any bill from your insurance.
Patients should know the requirements of their individual current plans. You should always know what your plan intends to pay for services, and what you will be responsible for. Your plan may change annually based on your employer’s contract with that plan.
Please talk to our billing department staff regarding any questions pertaining to insurance benefits.
The Medical Providers at Family Health Center of Mission