Accepted Insurance

We are participating providers with the following insurance companies and networks:

We accept Medicare, United Healthcare, Cigna, Multiplan, EVRY - PPO, Nexcaliber (AAGI) - PPO, Oscar Insurance Company of Texas - EPO, Prime Health Services, Inc - Group Health, Private HealthCare System PPO (MPI) - PPO, PROCURA/Optum - Federal WC, WC, & Auto, Tricare (Humana Military Health Plans), Blue Cross Blue Shield, Wellcare - Medicare Advantage HMO and Independent Medical Systems - PPO.

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More to come..


Insurance and Billing

Your participation with your insurance is contract between you and your insurance company. It is your responsibility to know your individual insurance benefits – including eligibility, annual deductibles, co-pays, coinsurance, covered benefits etc. Please contact customer service at your insurance company for any questions you may have regarding your individual benefits.

We participate in most insurance plans (see detail under the insurances accepted tab) and will bill your insurance plan as a courtesy to you. If we do not participate with your plan, payment in full is required at the time of service, unless other arrangements have been made in advance.

If you are insured, but we are not able to verify your eligibility in that plan, or if the plan states you are not eligible, payment in full will be required at the time of service (this applies to Cobra plans as well). It is your responsibility to provide our office with all active insurance policies at each visit, and to inform us in advance any time there is a change to your insurance.

If you have more than one insurance policy and you do not give us all of the information prior to your visit, you may end up being responsible for the entire bill. Particularly, if the insurance we did bill is not the primary payor. It is your responsibility to provide all insurance information to our office as well as informing all of your insurance carriers of all insurance plans you have coverage under. This is called Coordination of Benefits and your insurance requires you to update them with this information. You are responsible for any services not covered by your plan that have been assigned to patient responsibility. We post payments/denials/patient responsibility as your insurance instructs us to do so on the Explanation of Benefits (EOB). If you are disputing how a claim has been paid/denied/assigned to your responsibility, you will need to contact your insurance company. We cannot change how this is posted without a corrected EOB from your insurance company.

  • Proof of Insurance: All patients must complete and/or update our Patient Information Form at each office visit. You must furnish valid and up-to-date proof of insurance coverage and a copy of your driver’s license. If you provide false or expired insurance information you will be responsible for the balance of the claim. Please notify us of any changes in insurance coverage prior to the time of service. Insurance denials for Termination of Coverage, Pre-existing Conditions or Coordination of Benefits will be automatically billed to patient responsibility.
  • Co-Payments, Deductibles and Co-Insurance: All co-payments, deductibles and co-insurance amounts must be collected at the time services are rendered. We are contractually obligated to collect your patient portion and therefore they cannot be waived.
  • Claim Submission: We will submit your insurance claims and assist you in any way reasonable to help get your claim paid. At times, your insurance may deny paying your claims if they need you to supply information directly to them. It is your responsibility to comply with their request in a timely manner. Please note when insurance denies claims for this purpose, they have made the entire claim patient responsibility while they wait for you to comply. The sooner you respond to their request, the sooner the claim will be adjudicated by your insurance. Please be aware that the balance of your claim is your responsibility to pay whether or not your insurance company has paid. We are not a party to your insurance contract.

Please note: We do not accept Medicaid


Out of Network Commercial Plans

Rheumatology & Autoimmune Specialists recognizes that some of our patients may be without insurance coverage or may chose to receive care even when we are not “Participating Providers” with their insurance plan (“Out-Of-Network”). We have very reasonable Self Pay Rates for such instances. Please inquire for more details. All patients who are under Self Pay status will be required to make payment in full at the time services are rendered. We do not accept attorney liens or any type of contingency payments.

Insurance Office Visit Referrals

If your insurance plan requires a referral from our office for other medical services ie.. referrals to a specialist, radiological imaging, medical facility care, etc., it is your responsibility to inform the office of this requirement prior to referral. We require 48 hours notice to facilitate a referral request and cannot issue retroactive referrals.

Payment Policy

  • Prompt Payment: All patients, Insured or Self Pay status, will be required to make payment in full at the time services are rendered. In the event that we need to send you a statement after services have been rendered, you agree to make payment upon receipt of the statement without delay.

  • Non-Payment/Collections: Rheumatology & Autoimmune Specialists will ultimately send out three (3) balance due statements to you, followed by a certified letter notifying you of your final chance to pay the balance due, and, if still not paid, your account will be turned over to a collection company.

    Any patient on active collection status will not be seen until collection account has been confirmed to be paid with the collection company.

Financial Responsibility

Be prepared to pay your specialist deductible and co-pay amounts at the time of your office visit. Our office staff is available to help you to determine an estimate of these amounts in advance. We accept multiple forms of payment for your convenience, including personal check, credit card (MasterCard, Visa, Discover, and American Express), and cash.

Your insurance company requires you to pay your co-pay, so please do not expect them to be waived. Patient accounts that are past due and no payment arrangements have been made may be forwarded to a collection agency. Collection agency fees will be the responsibility of the patient. The fee for all returned checks is $30.