Insurance & Fees

Insurance & Fees

The following is the list of insurances with which we participate. This will be updated from time to time as needed:

  • Aetna – (No HMO Exchange, No ACO, No QHP, No BQA TRS, No Texas Health Resources EPO/HMO, No Smart Care or Image Health)
  • Aetna First Health – (Must say Aetna on card)
  • Baylor Scott & White – HMO, PPO, EPO (Some of our doctors are not yet in the BSW Quality Alliance network, which includes coverage for Baylor employees, BSW or TRS plans, please call our office to verify if your doctor is in network)
  • Beech Street – (PPO only)
  • Blue Cross Blue Shield – PPO, POS, HMO Blue (No Advantage HMO, No MyBlue Health (T2G), No Medicaid)
  • Blue Premier HMO Network
  • Choice Care – (Humana) (No Medicaid, No Humana Exchange)
  • Cigna – Most commercial plans, including Local plus (No Marketplace plans, No Focus BQA, No Medicare plans, No Health Spring)
  • Contigo Health (Formerly Three Rivers Provider Network)
  • First Health – Aetna HAS to be on the insurance card
  • Galaxy Health Network – PPO only
  • HealthSmart Preferred Care (90 Degrees) – Only in network if using Health Smart Preferred Network
  • Humana (Choice Care) – (No Medicaid, No Humana Exchange)
  • MultiPlan/PHCS – (PPO Only, No Discount Cards)
  • Texas True Choice – PPO/POS only
  • TriCare – Tricare for Life, Reserved Select, Select (Out of network with Tricare Prime)
  • United Healthcare/UMR/UH One/UH Shared Services – (No Exchange plans, No Medicaid plans, No Community Plan, No UHC Methodist)

*Medicaid participation is optional and varies amongst Privia Medical Group providers – Forest Lane Pediatrics does not accept Medicaid.

Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.

Payment Options

We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.

Card-on-File

We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.

At check-in we will:

  • scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card

After your insurance has paid their portion, we will:

  • notify you via email of the balance owed
  • charge the balance owed to your card on file
  • email a receipt for the charge

Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).

Fees

No Shows
Missed Appointment $25
Missed Physical $25
Late Cancellation $25
No-Show $25
Missed Procedure $200
Out-Of-Network
New Patients Total Charge or Minimum $200 Deposit
Established Patients Total Charge or Minimum $150 Deposit
Self-Pay
New Patients Total Charge Paid at Time-of-Service
Established Patients Total Charge Paid at Time-of-Service
Procedures Total Charge Paid at Time-of-Service

Additional Resources

Avoiding Surprises in Your Medical Bills

Avoiding Surprises in Your Medical Bills (Spanish)

Understanding Healthcare Prices: A Consumer Guide

Understanding Healthcare Prices: A Consumer Guide (Spanish)

Planning For a Medical Procedure