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Houston Medical Group Health Financial Policy and Procedures

At Houston Medical our number one focus is our patients. With this in mind, in addition to our medical services, we also offer Chiropractic Services, providing our physicians with one more option in your treatment. Giving our patients a choice in available treatment is our goal.

Please understand that payment of your bills is considered part of your overall treatment. In order to keep your cost of healthcare to a minimum, the following policies have been adopted for use at Houston Medical Group

Fees and Payment

Fees are standardized and based on the complexity of your visit. Payment in full of your insurance co-payment or the complete balance of the bill, if you are a self-paying patient, is required at the time of the service.

Required at Check-In

* Each time you check in for your appointment you will be required to:

* Verify personal contact information

* Present current copy of insurance card

* Pay any outstanding account balance

* Pay your insurance co-payment

Health Insurance Plans

As a courtesy to our patients, we will verify insurance coverage for all of our patients. We will also bill your insurance carrier on your behalf, and only collect the amount deemed your responsibility from your carrier. This will include payment for any co-payment at the time of service and for any deductible/coinsurance or non-covered services determined by your contract with your insurance carrier. We will do our utmost to help you obtain maximum benefits within the structure of your policy.

We accept patients carrying insurance from companies even if we are not on their network. Out of network insurance companies may approve our services at in-network rates if they do not offer comparable services through their provider lists.

While filing of the insurance claims is a courtesy that we extend to our patients, all charges are ultimately your responsibility. In order for us to file a claim, you must present a current copy of your insurance card at each visit and communicate any changes in your personal contact information to us.

Most insurance policies specify that some of the cost of care is a patient responsibility. This can be accomplished through any combination of co-payments, coinsurance or deductibles. Co-payments are due when you check in for your appointment. Coinsurance, deductibles, and other non-covered services are calculated by your insurance company and reported on your explanation of benefits. Once we are notified, we will add the appropriate charge to your account and send you a statement. This charge is due within 30 days of receiving the statement. Not all services are covered benefits in all policies, so it is very important that you understand the provisions of your individual policy.

If you do not see your insurance listed below, please call the office to speak with one of our knowledgeable staff members about your individual coverage.

Our practice participates with the following insurance programs:

Self-Pay

In order to address the needs of our patients without insurance and patients with insurance coverage limitations, we would like to offer a 20% discount off of our standard fees. This discount acknowledges the lower cost involved in billing and
collections when a claim does not need to be submitted with a third party payer. In order to qualify, payment needs to be made in full prior to or upon completion of the visit or procedure, and any outstanding balance remaining is not eligible for the discount. This discount applies to all medical services provided and is offered only at the time of service.

 Medicare

We accept patients with Medicare and will bill our services at the allowed rate. You will be required to sign an Advanced Beneficiary Notice (ABN) at each visit. This form will explain which services Medicare may not cover and that you may be
responsible for those charges. Any lab work performed will require a separate ABN to be filled out for the current laboratory provider.

Work and Auto Injury:

As a courtesy to our patients, we will verify insurance coverage and we will also help to file the proper paperwork to set up claim for all of our patients.

Injuries resulting work and auto accidents are covered 100%. Many in-home injuries are covered by home owner's policies. Our friendly staffs are trained to handles Worker's compensation and Auto Injury claims. Call us today if you should be any questions on your claim.

We welcome all referrals, including Workers' Compensation. Our physicians are approved and registered at all levels of service by the Texas Department of Insurance, Workers' Compensation Division and Federal Worker's Compensation

Worker's Compensation Carriers

Crime Victims Claim

The Crime Victims' Compensation program is available to assist victims of violent crime with expenses associated with the crime. In order to receive financial assistance from the fund, victims must complete an application for benefits. As a courtesy to our patients, we will verify coverage and assist you to file the proper paperwork to set up your claim.

The fund is able to pay for a variety of expenses including:

medical, hospital, physical therapy or nursing care

psychiatric care or counseling

loss of earnings or support

loss of wages due to participation in, or attendance at, the investigation, prosecutorial and judicial processes, and travel

care of a child or a dependent

funeral and burial expenses

crime scene clean-up

replacement costs for clothing, bedding, or property seized as evidence or rendered unusable as a result of the investigation

reasonable attorney fees for assistance in filing the Crime Victims' Compensation application and in obtaining benefits, if the claim is approved

loss of wages and travel to seek medical treatment

job training and vocational rehabilitation