Accepted Insurance Plans

KSF Orthopaedic Center, as part of Tenet Physician Resources and Tenet Healthcare, accepts most major health plans. Please check with your health insurance carrier to verify specific coverage. Plans accepted include:

• Aetna ( POS, HMO, EPO, PPO WC, MC ADV, NAP Premier )
• Alliance Political Subdivision – Workers Comp
• Ambetter (Marketplace & Medicare Replacement Only)
• American Health Plan (Medicare Advantage Plan)
• America’s Choice Provider Network (PPO)
• Amerigroup (Medicare Replacement Only)
• BCBS –TX (PPO, POS, EPO, HMO)
  • Blue Advantage
  • Blue Choice PPO
  • Blue Edge PPO
  • Blue Essentials Access
  • BCBS outside of TX – (BCBS IL, BCBS MI, etc)
  • Federal BCBS PPO (Gov’t Plan)
  • Health Select
  • Medicare Advantage HMO
  • Medicare Advantage PPO
  • Dual Special Needs Plan (DSN)
  • WellMed MA
  • HMO
  • POS

• Cigna (PPO, POS, HMO)
• Cigna HealthSpring (MC Adv & MC Adv SNP) **WITH REFERRAL**
• Clever Care
• CorVel/CareWorks National
• Department of Labor (DOL) – Federal WC
• Devoted Health Plan (MC ADV HMO)
• Employers Health Network
• Galaxy Health Network (Commercial PPO, Workers Comp)
• HealthSmart (Commercial PPO)
• Humana (Commercial PPO, MC HMO, PPO, PFFS)
• Humana Military
  • Tricare East (Select, Prime)

• Imagine Health
• Imperial Health Plan
• Independent Medical Systems (PPO, HMO)
• Medicare (Traditional)
• Medicare Railroad
• Multiplan
  • Beechstreet
  • PHCS
  • Savility
  • WC
  • Health Management Network

• Oscar Health – Marketplace Plan - Commercial
• Prime Health (PPO, HMO, WC/Sedgwick)
• Scott & White Plan
• Stratose / Zelis NPPN/Commercial PPO
• Superior Health Plan
  • Commercial / Exchange Plan
  • Medicare Advantage

• Three Rivers Provider Network (Commercial PPO)
• TriWest Healthcare Alliance (SPC Only)
• United HealthCare (UHC)
  • PPO, Select EPO, Select Plus HMO/POS, Choice EPO, Choice Plus HMO, Compass EPO/POS/HMO/HMO Plus, Navigate EPO/HMO/HMO Plus/POS, Nexus ACO, MC ADV)

• Wellcare (MC Advantage PPO)
• Wellcare/Texan Plus (MC ADV HMO)**
  • TXN Plus – Currently credentialing --- **With Referral/Authorization for visit**

Billing Information

Unless you are a member of one of our contracted insurance plans, or Medicare, full payment is due at the time of service. We accept cash, checks, Visa, MasterCard, Discover and American Express.

POS/PPO Plans

If the physician is contracted with your plan, the majority of members covered under this type of plan are still required to make some type of payment for service that is rendered to them. This may be in the form of co-payment, deductible, or co-insurance. If your plan has a co-payment, you will be expected to pay your co-payment prior to being seen by the doctor. Co-payments, deductibles and co-insurance are requirements of your insurance plan and we are required under our contract with these plans to collect these amounts from you.

HMO Plans

Most of the members covered under HMO plans also owe co-payments. Co-payments will be collected prior to being seen by the doctor. We are required under our contract with these plans to collect these amounts from you.

Balances on Account

All previous balances are to be paid in full prior to additional services being rendered.

Collections

Should it become necessary for us to utilize the services of an outside collection agency in order to collect the amounts that are owed, you will be liable for agency/attorney fees.