What You Need to Know for Your First Visit

 

  • For those patients on medications, please make a complete list of all medications that you are currently taking, and have recently taken. 

 

  • Please clearly communicate with your physician about your medication experiences and needs. 

 

  • Please bring a current picture identification card.

 

  • Please bring your current health insurance information with you at each visit to ensure that we maintain your correct information on file. This allows us to submit your insurance claim to your insurance carrier in a timely manner.

 

  •  It is very important that you please evaluate your medication supply before your office visits and try to correlate all refills with your scheduled appointments.

 

  • If you have been treated by a physician or hospital for the reason you are visiting us (example: allergies, asthma, hives, anaphylaxis), then you may want to request copies of pertinent medical records in advance of your appointment. You may either have them give the records to you directly, or they can fax them to us.

 

 

 

 

 

Understanding Health Insurance Terminology

 

  • Copay:  A co-pay is a set dollar amount that the patient is responsible for paying for medical services.

 

  • Deductible:  A deductible is specified amount of money that the insured (patient) must pay before an insurance company will pay a claim.

 

  • Co-insurance:  Co-insurance means that the insured pays a share of the payment made against a claim. For example, 20% of the allowed amount would be a co-insurance.

 

  • Explanation of Benefits (EOB):   An Explanation of Benefits, (commonly referred to as an EOB) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf and also explaining the amount that the insured is responsible for paying. It is not a bill it is just an explanation of payment.

     

  • Allowable contract rate:  The allowable contract rate is the amount that the provider is actually paid for services billed. There is usually a discount applied depending on the contract that the provider has with the insurance company.

 

Patient Resources //

Frequently Asked Questions (FAQs) 

​​Why aren’t all services covered by my insurance company?

 

Under any plan, there may be services that are not covered because the insurance company may consider them routine or unnecessary. If you disagree with the decision, you should contact your insurance company for more information.

 

Why do I still owe a balance if my insurance company has been paid?

 

Based on your insurance plan, you may be responsible for deductibles, co-pays and co-insurance for fees not covered by your insurance company.

 

A copayment is a set fee the member pays to providers at the time services are provided. Copays are applied to emergency room visits, hospital admissions, office visits, etc. The cost is usually minimal. The patient should be aware of the copayment amounts prior to services being rendered.



What is a deductible?

 

Deductibles are provisions that require the member to accumulate a specific amount of medical bills before benefits are provided. For example, if a member’s policy contains a $500 deductible, the member must accumulate and pay $500 out of pocket before the insurance carrier will pay benefits. Once the patient has met their deductible, the carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are yearly, usually starting in January.



What is co-insurance?

 

Co-insurance is a form of cost sharing. After your deductible has been met, the plan will begin paying a percentage of your bills. The remaining amount, known as co-insurance, is the portion due by the patient.

Generally Accepted Health Plans //
  • AARP

  • Aetna

  • APWU

  • Assurant Health

  • Blue Cross Blue Shield

  • Champva

  • Cigna Healthcare

  • CONNECTICUT GENERAL

  • Coventry Advantra

  • First Health

  • Freedom Life

  • Geha

  • GPA

  • Great West

  • Group and Pension Admin

  • Group Resources

  • HealthChoice

  • HealthSmart

  • Healthspring

  • Humana

  • Mail Handlers Benefit Plan

  • Medicare

  • Meritain Health

  • MultiPlan

  • Mutual Assurance Admin

  • NALC

  • Pacificare

  • PHCS

  • Railroad Medicare

  • RSL Specialty

  • Samba

  • Starbridge-Cigna

  • Sterling

  • Texas True Choice

  • Tricare

  • Tricare for Life

  • True Choice USA

  • UMR

  • United Healthcare

  • Uprehs

© 2014 by McCart Medical Associates.

7120  McCart  Avenue,   Fort Worth, TX  76133

To Schedule An Appointment

Call 817.294.5624​