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Insurance

We recommend contacting your health insurance provider to obtain the most updated network participation status, as online lookup tools are not always accurate. It is important for you to understand your insurance benefit details for wellness and sickness visits, as having insurance does not mean that all visits will be covered at 100%.

We accept most commercial insurance policies including but not limited to:

  • Aetna

  • Aetna Marketplace

  • Allied

  • Allsavers

  • Ambetter

  • Anthem 

  • Blue Cross Blue Shield

  • Cigna

  • Cigna Marketplace

  • Healthsmart

  • Netwell

  • Meritain Health

  • Multiplan

  • PHCS

  • Premera Blue Cross Blue Shield

  • Superior Health Plan

  • Surest

  • Trustmark

  • UMR

  • United Healthcare

  • United Healthcare Marketplace

  • US Health Group

We are not accepting New Patients with Medicaid or CHIP insurance at this time. 

We are Out-of-Network with the following policies:

  • Ambetter Value Plan

  • Baylor Scott and White Plans

  • Baylor Scott and White Marketplace

  • Blue Cross Blue Shield - My Blue Health

  • Blue Cross Blue Shield Marketplace

  • Bright Healthcare

  • Cook Children's

  • Friday Insurance 

  • Oscar Insurance

  • Tri-care 

  • United Healthcare Texas Star

  • United Healthcare Charter

Understanding Your Insurance Benefits

Our office staff does our very best to help you understand your insurance benefits, however it is strongly recommended for you to speak to your insurance to fully understand your specific plan's benefits, as they vary from policy-to-policy. You can locate your member services phone number on the back side of your insurance card. Your eligibility and benefits are verified prior to each appointment, if possible, and claims are processed before balances are collected. 

View the back side of your insurance card to contact your plan's Customer/Member Services line. It is recommended for you to

ask questions regarding general benefits for a(n): annual wellness visit, duration between annual wellness visits, routine immunizations, and a primary care office sick visit. 

One Well Child Check (annual checkup, physical exam, wellness visit) is typically covered by your healthcare policy each year. We recommend keeping these 365 days from your last visit to ensure coverage, however some insurance policies allow one per calendar year or birthday.

  • This visit includes vision and hearing exams, developmental screening, vital screening, physical body and spine exam, and orders for routine bloodwork.

  • If your child is sick during their wellness visit and/or other non-preventative items are discussed with the doctor, you may receive an additional charge that are subject to a copay, coinsurance, and/or deductible. 

A deductible is the amount you will have to pay for medical care at the beginning of your insurance policy.

For each policy year, you'll pay the full cost of most medical care until your total spending reaches the deductible amount. Then you'll split your health care costs with the insurance company (based on your co-insurance) until you reach your out-of-pocket maximum.

The out-of-pocket maximum is the limit on your medical expenses for the year.

After your spending reaches this amount, the insurance company will pay all costs for covered health care services.

*While we are here to help you, your understanding of your insurance benefits are ultimately your responsibility. We are not your insurance payer, and are unable to answer all questions related to insurance. Please be respectful to the staff. 

Any questions regarding a balance or billing statement can be addressed to our billing department:

Top Resource Medical Billing 

Phone: 972-207-8401

Fax: 214-710-2156

mybill.trmb@gmail.com

Office Hours: Mon-Thurs 8:30am-4:30pm, Friday: 8:30am - 12:00pm

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