Our office is accepting only New Patients from the list of Insurances below:
-BCBSTX..... We are not in network with MyBlue Health Plan, HPN Open Access HMO
-Cigna.... We are not in network with Cigna Local Plus Plan and HMO Texas Connect
-United Healthcare.. We are not in network with Charter Plans
P.S. Always contact our office first to verified if we are in network with your Insurance plan.
LOVING CARE GROUP FINANCIAL AGREEMENT
We are committed to providing your child(ren) with the best possible medical care.
If you have special financial needs, we are willing to work with you.
The following information is provided to avoid any misunderstanding or disagreement concerning payment for professional services. We will file primary insurance as a courtesy;
however, YOU ARE ULTIMATELY RESPONSIBLE FOR YOUR CHILD(REN)’S CHARGES.
Our office participates with a variety of insurance plans. It is your responsibility to:
· Bring your insurance card and photo I.D. at every visit.
· Pay your Co-Payment and/or any deductibles at each visit.
· Pay in full for any medical care or services that are not covered by your insurance plan.
-If your child(ren) has insurance that we do not participate with, or your child(ren) does not have insurance, payment in full is expected at the time of service.
Your child(ren) visit will be considered as a private pay patient in our office.
-If your insurance plan is HMO or POS policy, it may require you to choose a PCP (Primary Care Provider). You will need to switch your PCP before prior to making any appointments to be seen with us. We will be unable to see your child(ren) until this change is made.
-We as a courtesy will file the office visit to your secondary insurance claims for federal and state sponsored health insurance carriers, but you are financially responsible for any amount not covered by your child(ren)’s plan or any charges incurred in your child(ren)’s care and treatment.
-If you have questions about your insurance, we are happy to help. However, specific coverage issues should be directed to your insurance company member services department. The phone number is usually located in your insurance card.
-If you fail to make a payment for services that are rendered to you and meet your financial obligations could lead to dismissal from the practice.
-Some services may not be covered by your insurance carrier. If you choose to receive services later denied by your insurance carrier, you will financially responsible for the balance on your account.
Loving Care Group LLC PEDIATRICS Advanced Beneficiary Notice: some services may NOT be covered by your insurance carrier or the charges will be applied to your deductible. The purpose of this is to informed you about whether if you choose to receive one of these services in the office and it is not covered or later denied by your insurance carrier, you will be financially responsible for the balance on your account.
I, (the patient) understand this and agree to be financially responsible and make full payment.
THANKS FOR YOUR COOPERATION!!!!