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

Missed Appointment Fee Notice

San Marcos Family Medicine strives to accommodate all our patients in a timely manner. We schedule our appointments so that each patient receives the right amount of time to be seen by our providers and staff. Because it is important that you keep your scheduled appointment with us, we will send courtesy appointment reminders at the time you schedule your visit, 3 days prior to your visit, and again the day before your visit. If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those patients who are waiting for an appointment. We require a minimum notice of 24 BUSINESS hours for cancellations or rescheduled appointments and are unable to make schedule changes after hours or during the weekend. If you do not provide appropriate notice for a cancellation or rescheduled appointment, we will require a $40 “no-show” service charge prior to scheduling any future appointments. This “no-show charge” is not reimbursable by your insurance company and will be your sole responsibility. For failure to provide appropriate notice for a cancellation or rescheduled appointment after the initial “no show”, we will require a $100 “no-show” service charge and a $200 deposit prior to scheduling any future appointments. Patients who fail to provide appropriate notice beyond this point may be subject to dismissal from the practice. Click Here to Know More

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.