If
you have insurance coverage, we will prepare and
submit the required insurance claim form to your
insurance company for services rendered in our
office.
We are happy to process your insurance claims
with our participating plans. We ask that you
present your insurance care, photo
identification, and any applicable co-payment
the front desk when you arrive for your visit.
If you have an HMO, MC or POS insurance plan,
your insurance card must have our practice name,
or one of our physicians, imprinted on the front
of your card. If our name is not on your
insurance card, unfortunately we will not be
able to see you until it is rectified. For our
self-pay patients, payment is expected at the
time of service.
Durbin Family Practice Financial Policy:
Thank you for
choosing Durbin Family Practice as your
healthcare provider. We are committed to
providing you with quality and affordable
healthcare. This financial policy was developed
to assist you have or that may arise with
regards to financial issues. We believe that
starting our expectations with regards to
financial issues helps us concentrate on our
mission of providing exceptional healthcare
-
All
new patients must fully complete our Patient
Information Form before seeing the doctor
-
Full payment
for our services is due at the time of
service, unless other mutually agreed upon
arrangements are made with our staff
- Insurance:
You are responsible for timely payment of
your account. Insurance is a contract
between you and your insurance company. We
are not a party to this contract, nor can we
become involved in disputes between you and
your insurer regarding deductibles,
copayments, covered services, secondary
insurance, “usual and customary charges’,
etc. Our involvement will be limited to
supplying factual information to facilitate
claim processing.
1. HMO and PPO:
copayments will be required to be made at
the time of your visit, as well as
deductibles, when applicable.
2. Medicare:
We are
a participating Medicare provider, thus we
accept assignment on your claims. We are
required by Medicare to file your claims for
you. Medicare will pay us directly and
provide you an EOB (explanation of benefits)
detailing allowances, payments, or denials.
3. Third Party Insurers:
We
do not file claims to companies for which we
are not providers. We will provide you the
information you need to submit your claim.
Know Your
Benefits
We are partnering with you in
your healthcare. Therefore, every patient needs
an in depth knowledge of their own insurance
information. While we wish to provide the best
care, any non-covered benefits are patient
responsibility. Therefore, we motivate our
patients to be very aware of what their personal
health coverage contains.
However, in order to
submit your claim we will need you to sign An Assignment
of Benefits form. An Assignment of Benefits form gives
your insurance authorization for payment to be made
directly to us for the services we provide to you.
Below is a list some of
the most common insurance plans we accept:
|
AETNA (HMO, PPO, POS, W/C) |
MULTIPLAN |
|
BEECH STREET |
MUTUAL OF OMAHA |
|
BLUE CROSS BLUE SHIELD (HMO, PPO, POS) |
ONE HEALTH PLAN |
|
CCN HEALTH NETWORK |
PACIFICARE |
|
CENTRAL STATES |
PHCS |
|
CIGNA (HMO, PPO, POS) |
POLY-AMERICA |
|
CORVEL (W/C) |
SECURE HORIZONS |
|
GALAXY HEALTH |
TEXAN PLUS |
|
GENERAL AMERICAN LIFE |
TEXAS TRUE CHOICE |
|
GREAT WEST (PPO) |
TPA |
|
GROUP BENEFIT SERVICES |
TRICARE |
|
HEALTH CHOICE |
UNITED HEALTHCARE (HMO, PPO, POS) |
|
HEALTH EZ |
UNITED PAYORS AND PROVIDERS |
|
HEALTH SMART |
WELL CARE |
|
HUMANA |
WORKMAN'S COMPENSATION |
|
METRO WEST |
|
| |
|
You can reach
us at (817) 640-5412 and
by fax at (817) 633-6630. We are looking forward to
hearing from you. Please let us know what your needs
and questions are, we will be more than happy to help you.
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