Confirming Coverage

We’re happy to assist in coordinating your healthcare insurance filing, but please confirm your insurance coverage prior to seeing Dr. McHenry.

We’re pleased to be participating providers for most Medicare plans and a large number of other major health insurance plan and we’ll do our best to assist and coordinate patient insurance coverage with our participating health insurance providers. Due to constant changes in healthcare and insurance policies, however, it is becoming increasing difficult to know each and every individual policy and benefits.  Therefore, it is the patient’s ultimate responsibility to understand what coverage their healthcare insurance provides for their medical care, and in some cases, the patient will be financially responsible for medical treatment not covered by their insurance.

We also offer a self-pay option for those who do not have or will not be using insurance with more important details below.   The self-pay option is not available for Medicare patients at this time.

Medicaid Patients

Unfortunately, due to circumstances beyond our control, we no longer accept Medicaid. If you are a Medicaid beneficiary and would like to see Dr. McHenry, you will be directly responsible for the charges. Please ask about the Self-Pay rates if you are interested.

Preauthorization Requirements

Many health insurance plans require referral authorization from your primary care physician prior to consultation with a specialist. In addition, most plans also require preauthorization before any type of surgical procedure or specialized treatment. It is your responsibility to obtain the required referral authorization from your primary care physician.

Failure to obtain a referral authorization, if required, will result in your health plan denying payment for our services. In this case, you will be financially responsible for all services obtained through our office.

If you are uncertain whether your health plan requires referral preauthorization, please call your plan’s customer service representative or your primary physician’s office.

Please Bring Your Insurance Card(s)

Please bring your insurance card(s) with you to each and every visit so that we have accurate information about your coverage. This includes Medicare patients. If you have questions about our participation in your insurance program or health plan, please call our offices at (214)753-8500.

Payment for Services

Many plans require a co-payment and we are required to collect co-payments at the time of your visit. You will also be charged for any deductibles or out-of-pocket expenses that must be paid at the time of service.  You are financially responsible for your portion of the balance after your plan has paid its part of the charges. If you do not have medical insurance, you will be expected to pay for your office visit and exam at the time of your visit unless you have made prior arrangements with our billing office.

Self-Pay Patients

When you contact our office, please let us know if you are going to be a self-pay patient.  As a self-pay patient, you are entitled to a “Good Faith Estimate”:

What is a “Good Faith Estimate”?

Patients who will not be using or do not have insurance have the right to an estimate of their bill upon request for health care items and services before those items or services are provided.  Upon request, we will provide a “Good Faith Estimate” prior to receiving your medical items or services.  We will provide your requested “Good Faith Estimate” in writing for scheduled or unscheduled services within a specific timeframe.

Please be sure to save an image or copy of your “Good Faith Estimate.”

If you receive a bill for any provider/facility that is at least $400 or more than the “Good Faith Estimate” you received, you can dispute that bill using a procedure set forth in the CMS webpage listed below.  Please see that page for more information.

For questions or more information about your right to a “Good Faith Estimate,” we encourage you to visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.