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
Amerigroup
BCBS TX
Cigna
Galaxy Health Network
Healthsmart
Humana
Humana Military Non-Network
Medicare Railroad
Medicare Revalidation
Medicare Traditional
MHealth
Molina Healthcare Marketplace
Multiplan/PHCS/Beechstreet
Oscar
Tricare/Humana Military (In Network)
UHC (EPO/PPO/HMO/POS)
UHC Community Plan
UHC Medicare

*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.

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
Missed Physical $100
Late Cancellation $50
No-Show $50
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 or Minimum $200 Deposit
Established Patients Total Charge or Minimum $150 Deposit
Procedures Total Charge or Minimum $200 Deposit

Referrals and Prior Authorizations

Some insurances may require referral authorization or prior authorization for specialist visits or diagnostic testing. The process to obtain authorization varies by insurance carrier and may take up to 10 days for completion. While San Marcos Family Medicine strives to provide high-quality services for our patients, we do ask you allow appropriate time for our staff to complete this process prior to scheduling services to ensure your visit or testing will be covered.

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