Insurance & Fees

Insurance & Fees

WE ACCEPT AND ARE IN-NETWORK WITH THESE MAJOR INSURANCE PLANS

  • Aetna – PPO, POS, EPO, Includes TRS-Active Care Plans, Premier Care Network, Aetna with TRINET on card, Pref Plus II
  • *(WE DO NOT ACCEPT: Aetna HealthEZ; Texas Health Resource or Any kind of TEXAS HEALTH CARD) **Aetna Premier Care TH+A Network*
  • Aetna First Health – Note: The card must say Aetna on it
  • Anthem Blue Cross & Blue Shield
  • Blue Cross & Blue Shield – PPO; Blue Essentials HMO; Blue Cross Blue Shield Health Select, Horizon,
  • Blue Cross Medicare Advantage
  • Choice Care (HUMANA), ‘Humana One’ individual plans
  • CIGNA (PPO, POS, HMO, FLEX, LocalPlus PPO, Open Access, Select Network, Cigna Freedom Life, Cigna Allegiance)
  • First Health – The card must say Aetna on it
  • GPA – We are in network if there is a logo on the card for one of the networks we are already on MultiPlan, PHCS, Beech Street, Cigna, etc.
  • Healthscope thro’ BSWQA – Dart Employees Only
  • HealthSmart Preferred Care
  • Humana Medicare Advantage Networks
  • Humana Choice PPO, Humana Prime Choice PPO, & Humana Gold Choice PFFS
  • Humana One Individual plans (Choice Care) – NO Humana Gold HMO
  • Medicare & Railroad Medicare
  • MultiPlan – PHCS (PPO Only)
  • PHCS (PPO ONLY) thro’ Multiplan
  • Scott & White Health Plan Commercial HMO, PPO and EPO and Marketplace plans “Firstcare”
  • TRICARE EAST – (Prime, Standard, Reserve Select, Tricare for Life)
  • United Healthcare – Commercial Plans – Health Select, PPO, HMO
  • United Healthcare – UMR/HEALTHONE/BIND
  • United Healthcare NEXUS ACO through BSWQA
  • United Healthcare – Medicare Advantage (AARP 1&2 HMO/ Regional Gold / Silver / Regional Complete Choice / Health Select/UHC Nursing Home Plan (PPO SNP) Formerly Secure Horizons; UHC – TRS, “Medicare Complete” “Medicare Essential”
  • Wellmed (NOT Wellcare)


WE ARE NOT ACCEPTING THE FOLLOWING INSURANCES AT THIS TIME: 

  • Aetna – HMO Exchange, Aetna ACO, Smartcare/Imagine Health, Aetna Medicaid or Aetna Medicare Advantage
  • Blue Cross & Blue Shield – Any BCBS Blue Advantage Plans, including HMO Network (“BAV” on card); BCBS – UT Southwestern despite Texas Health Logo
  • Christian Care Ministries/Shared Plans
  • Humana – Humana Preferred Network, Humana Medicaid
  • CIGNA – Medicare Advantage plans
  • MultiPlan Discount Plans
  • PHCS (thro’ Multiplan) – No Discount Plans
  • Scott & White Medicare Replacement Plans
  • Three Rivers
  • United Healthcare – Methodist, Charter United Healthcare Exchange Plans, UHC Medicaid Plans, UHC “Community Plan,” “Dual Complete” – Freedom Network-Oxford Life
  •  Wellcare

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 $50
Late Cancellation –
less than 24 hours or same day
$50
No-Show $50
Missed Procedure $200
Out-Of-Network
New Patients We do not take out-of-network
Established Patients We do not bill out-of-network
Self-Pay
New Patients Payment in full at time of service
Established Patients Payment in full at time of service
Procedures Payment in full 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