We offer the following tips and resources to help you with the insurance and billing process:
We recommend you review your family’s health insurance policy and become familiar with your co-pays, deductible, and co-insurance, the services, tests and treatments covered, and the steps required to get referrals.
If your insurance company requires a referral for testing or future visits, you will need to contact your primary care physician (PCP) to get the required referral and make sure it is processed before your appointment.
A referral is a requirement by some insurance plans in order to gain authorization for a test, visit, or procedure. With those plans, your insurance company must process and authorize the referral before the test, visit, or procedure is covered by your plan. Otherwise, you will arrive for your appointment and face a large self-pay charge that must be paid in full before the service can be rendered.
Remember that you are responsible for all referral fees and co-pays.
Families receiving Medicaid should monitor all changes in their coverage.
Each Medicaid plan has different covered benefits. These plans and covered benefits change annually. Depending on where you are in the plan year, the rules may change during the course of your care. These changes may impact what doctors and hospitals your plan covers, the covered services, as well as your associated deductibles and copays.
Check your insurance coverage every six months to make sure your insurance is still accepted by Texas Children’s Hospital.
