I am in network for these insurance companies:
- BlueCrossBlueShield (including ACA Exchange)
- United Healthcare (Optum)
- Tricare (standard provider, not Prime)
- Humana (no Medicare Advantage plans)
- Galaxy Health Network
- Beacon / ValueOptionsBeacon / ValueOptions
I have applied for in network status for these companies but they have not yet responded:
- Multiplan / PHCS
- USA MCO
I also accept most out of network insurance plans, but your deductible is usually much higher for out of network care.
If you’re a former patient of mine from Texas Health Behavioral Health, I will accept your usual co-payment as payment in full until the pending insurance companies listed above get around to finalizing my contract, or until mid 2017 if they never do. It might help to contact them and ask that they move things along!
This is not a guarantee of coverage – please check with your insurance company to verify network participation status, deductibles and coinsurance. The health insurance market in the United States is very complex – failure to understand your insurance benefits and rights can cost you a lot.
Fair Health has a ton of resources to help you understand how to best utilize your insurance benefits.
Most of the time, I can file directly with your health insurance and you will only be responsible for co-payments and deductibles. If preferred, I can provide you with a detailed invoice or a standard insurance claim form that you can use to file a claim with your insurance company.
Prompt Payment Discount
Upon request, a 25% discount may be applied to services that are paid in full at the time of service. This discount is available without regard to insurance coverage or benefit plan, however the patient or responsible party’s health plan benefits may be reduced if a prompt pay discount is requested.
Statements are sent through the onpatient portal and are due upon receipt. If a paper statement must be mailed an additional statement fee of $25 per statement will be applied.
Follow up Appointment Booking Deposits
A deposit of $35 (the average insurance copayment) is required at the time of booking an online follow up appointment. This deposit will be applied toward the session fee, or the balance left over after insurance.
The responsible party remains liable for all charges, whether or not they are covered by insurance. Please be sure you fully understand your insurance benefits and my financial policies before arriving for your first appointment.
Credit balances remaining on a patient’s account are refunded monthly, unless the responsible party requests otherwise.
Texas law requires insurance companies to pay claims within thirty days of filing. As such, it is my policy that the responsible party must pay the insurance portion of a claim if payment from the insurance company has not been received within 60 days.
Patients with overdue balances will only be seen for emergencies.
Non medically necessary services requested by the patient are not covered by insurance and are charged at a standard fee of $300 per hour (minimum $25). Medically necessary services are health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine. Examples of non-medically necessary services are completion of disability forms, FMLA forms, prescription pre-authorizations, completion of life insurance applications and duplication of medical records.
Cancellation Policy – Regular Appointments
Your appointment time is reserved for you and you alone. Broken appointments or appointments canceled with less than 48 hours advance notice will be billed to the patient at $100.00, unless the time is filled by another patient. In case of winter weather, cancellation fees will not be charged if Dallas or Richardson Public Schools are closed.
Insurance companies generally do not reimburse cancellation fees.
Patients may request a written estimate of their out-of-pocket expenses. Charges may vary based on the patient’s condition. The request may delay the scheduling of your care. The actual charges may differ from the amount paid by the third-party payer. The patient is personally liable for the services not paid by health insurance.
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