Billing

Insurance

We have contracted with many insurers and health plans to accept an assignment of benefits. This means that we will bill those plans which we have an agreement and will only require you to pay the authorized co-payment, deductible and/or co-insurance at the time of service.

It is the responsibility of the guarantor to know the benefits associated with their insurance plan or coverage and to obtain all referrals and authorizations from the primary care physician, when applicable. If we do not have a current referral or authorization on file, you may be asked to reschedule your appointment.

If the patient has secondary insurance or insurance primary to Medicaid, this information must be given to our office at the time the appointment is scheduled. We are required by our insurance contracts to bill each policy a patient has. This is especially important for patients with Medicaid. Billing all insurance plans will only lower the total patient responsibility, not increase it.

It is the guarantor’s responsibility to know where their insurance company requires them to obtain labs, x-rays, or other ancillary services. Please let your doctor’s medical assistant or nurse know so that they may schedule tests accordingly.

In the event that your health plan determines a service to be “not covered,” you will be responsible for the complete charge. Payment is due upon receipt of a statement from our office.

If we do NOT participate with your insurance company, you will be considered a self-pay patient. The policy for self-pay patients, as seen below, will apply. As a courtesy we can provide all necessary information for you to bill your insurance.

Self-Pay Patient

If you do not have insurance you will be considered a self-pay patient, which means upon arrival, before seeing the doctor, you will need to make a deposit of $150.00. After your visit CHECK-OUT will collect the remainder of the balance in full. Depending upon the total amount due, payment arrangements may be available. The maximum time frame to pay a balance in full is three months.

Surgery

Surgery deposits are due a minimum of five business days prior to surgery. If for any reason surgery needs to be canceled it must be done 10 business days prior to the surgery date or a $150.00 cancellation fee may be charged. Payments for surgery are accepted online (click the link at the top of the page) or call Surgery Scheduling at: 512-472-6134 and choose Option 3, then Option 2.

There are several components to your surgical bill. Expect to receive at least 3 different bills after surgery. You will get a bill from us, the anesthesiologist, and the hospital. It’s also possible to receive statements from other entities that provide services during the surgery.

Your insurance company has negotiated a discounted fee for your visits and surgeries. This is the amount that will be charged to you for your dependent’s visit or surgery. Not all insurance companies cover all expenses. When this happens, you are responsible for the charges.

Billing Transparencies

Understanding your benefits will help avoid confusion and misunderstandings during your child’s visit to the office or hospital.

Although you may have an office copayment, there are other services that are not covered by your copayment. These include ultrasounds, uroflows, lab work, etc. These usually fall under your deductible. Please check your coverage prior to your visit so that you are informed of your benefits.

Payments

We accept cash, checks, debit cards and credit cards. We also accept Care Credit (healthcare financing) to assist with any out-of-pocket expenses.

Payment is due at the time of service. Deposits and payments for surgeries are due prior to the scheduled procedure.