Insurance and Financing Information
Orthopaedic injuries and conditions are afflictions that can often have debilitating effects on your health and your livelihood. Therefore, treatment for these conditions are frequently covered or partially covered by insurance. All-Star Orthopaedics works with all major insurance companies, and can help you with the paperwork necessary to find out if you are covered and make your claim. We also work with care credit to make it easier for you to off-set the cost of treatment with affordable, low-interest payment plans.
Our orthopaedic surgeons understand that vital treatment can sometimes depend on your budget. That’s why we offer a range of options to help you with the ability to pay for procedures that can go a long way in restoring function to your body and improving your livelihood.
For more information on orthopaedic insurance and financing, please contact our practice in the Southlake, Flower Mound, Irving, and Dallas, Fort Worth, Texas region.
Insurance and Financing
At All-Star Orthopaedics we accept patients with work related injuries and or cash paying patients. For your convenience, we accept cash, personal checks, Master Card, Visa, Discover, and American Express. We also offer financing options through Care Credit.
All-Star Orthopaedics works with a large number of both private and federal insurance carriers, including:
- Blue Cross/Blue Shield
- BCE Emergis
- CCN Motorola
- Choice Care
- Federal Worker’s Comp
- First Health
- Galaxy-Under USA PPO
- Galaxy PPO
- Health Advantage Motorola
- Independent Medical Systems
- Managed Care Inc.
- Multi-Plan PPO/WC
- National Healthcare Alliance
- North TX Healthcare
- One Health Plan
- Plan Vista Solutions
- Medical Control
- Provider Networks of America
- Regional Healthcare Alliance
- Secure Horizons
- Southwest Medical Provider NW
- Southwest Preferred NW
- Student Insurances
- Texas Healthchoice
- Texas Instruments First Health
- Texan Plus
- Texas True Choice
- Tricare Standard
- Unicare “Classic”
- United Healthcare
- VHA-SW Pref NW
- Workman’s Comp
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider.
You’re protected from balance billing for:
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protection from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
- Cover emergency services by out-of-network providers. Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.
If you think you’ve been wrongly billed:
- Contact our billing department at 817-421-5000.
- Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.
- For more information about your rights under Texas law, contact 888-973-0022.