Confused about your insurance coverage? Rest assured…you aren’t the only one! For our patients, we’ve put together some information to help you through this process. Please contact us for this handout. For additional information, theTexas Department of Insurance maintains an excellent website for consumers. www.tdi.state.tx.us/consumer/cbo05.html - “Your Health Care Coverage”. We highly recommend you reference this website for answers.
We believe that physicians, patients, and insurance carriers enter into a three-way relationship to provide medical care. Our responsibility is to provide the highest quality medical care for your child and according to our contract, file insurance claims on your behalf. Your role is to provide us with accurate filing information, know your benefits, and be sure that your insurance carrier is paying claims. Your insurance carrier has the responsibility to pay claims promptly and accurately without undue delay. Should any part of this triangle fail to uphold their responsibility, the relationship suffers. We ask that you become PROACTIVE in assuring your insurance company pays claims promptly, accurately, and in accordance with your plan benefits.
We accept many insurance plans. We file claims on your behalf if we have a contractual relationship with your insurance carrier or its designated provider network. Listing all of these insurance carriers and networks would be onerous. One network may contract with as many as 50 insurance companies. If you are uncertain whether we are an in-network provider, please call our office. We always recommend before selecting a new insurance carrier that you call us and verify our status as a participating provider.
The following policies have been adopted in order to assist us in filing claims timely and accurately.

1. Your current insurance card is required at each visit. You will be asked to verify your insurance at each visit for each child. Often your insurance company redirects claims processing and claims administration to a different address, phone number, etc. This is why we need a correct insurance card each time!
2. Copays, coinsurances, and deductibles are due at the time of service.
3. Claims denied due to inadequate or incorrect information provided at time of service will become the parent responsibility.
4. Should you present in our office without current insurance information, you may be required to pay in full or obtain the necessary information from your employer prior to your child receiving services.
All insurance and billing services are performed in our office, not by an outsourced billing service. Our insurance staff is extremely competent in answering all insurance and billing questions. You may reach them at 512-241-0546.
There are many reasons for account balances. Some account balances may relate to increased copays, deductibles, co-insurances, and benefits that have been “maxed” out. Account balances may also signal problems with your insurance that requires YOUR intervention.

MISSED DEADLINES: Many insurance carriers have very short filing deadlines. If you have not provided us with correct information at the time of service or you have failed to update your insurance for each child, the filing deadline may be missed resulting in denial of payment. In these cases, the billed charges become parental responsibility.

COLLECTIONS: Please respond to your billing statements. It is our way of letting you know there may be a problem with your insurance coverage or interpretation of your plan benefits. Failure to resolve overdue balances can result in turning your account to a Collection Agency.