FINANCIAL/Insurance INFORMATION

 

FINANCIAL OVERVIEW

HEADACHE SPECIALISTS OF OKLAHOMA IS ‘IN NETWORK’ AND/OR ACCEPTS THE FOLLOWING INSURANCES:

  • AARP

  • Blue Cross Blue Shield

  • Cigna

  • Community Care

  • Medicare

  • Medicaid (Oklahoma)

    • ***Note: that if you have Oklahoma Medicaid (primary or secondary insurance), you will be required to have an active/up-to-date SC10 on file for your appointments, as well as for any procedure that is recommended.

    • Please inquire about the new Medicaid Plans! We are only in network with Humana Medicaid.

  • Humana

  • United Healthcare (including United Healthcare Choice Plus Network, UMR, and United Healthcare Medicare Replacement)

  • Healthchoice

  • Healthcare Highways, select plans*

    • You will need to contact your plan specifically to ask if we are in network.

  • QuikTrip

  • VA Community Care Network

    • You will need a current referral for our new location. There is a form we can fax for you to request this referral if you were a previously established patient of Dr. Duvall at Utica Park Clinic.

  • Tricare East

    • We are a participating non-network provider with Tricare East/Humana Military. We are able to see the following patients: Tricare Select, Tricare Reserve Select, Tricare Retired Reserve Select.

    • For Tricare Prime members: It is our understanding that you are required to see network providers. If you elected to be seen at HSOO, you would be responsible for deductible and cost share. We recommend you contacting Tricare directly for questions. It is our understanding that in some circumstances you may be able to get a referral that is approved to a non-network provider and in that case we would be able to see you at HSOO.

HEADACHE SPECIALISTS OF OKLAHOMA IS ‘OUT OF NETWORK’ AND DOES NOT ACCEPT THE FOLLOWING INSURANCES (YOU CAN STILL BE SEEN AT HSOO AS DETAILED BELOW IN OUR ‘OUT OF NETWORK’ EXPLANATION):

  • Aetna *We are very sorry and understand that this impacts a number of you. Unfortunately Aetna was not able to meet Medicare rates for reimbursement and as such we were not able to accept their contract. We suggest reaching out to Aetna if this upsets you but there is nothing further we can do at this time.

  • ChampVA We are not in network with ChampVA. If you have ChampVA as either your primary or secondary insurance, you will be billed directly for any services rendered.

‘OUT OF NETWORK’ PLANS:

For insurance companies that we do not accept, we are considered ‘out of network’ providers. You are welcome to be seen at our practice, but this is through a ‘fee for service’ payment. ALL SERVICES AND TRANSPARENT FEES ARE INCLUDED HERE. FULL PAYMENT IS DUE AT THE TIME OF SERVICE. A BILLING SUMMARY WILL BE PROVIDED AFTER YOUR VISIT WHICH YOU MAY SUBMIT TO YOUR INSURANCE PROVIDER FOR REIMBURSEMENT (PLEASE SEE DETAILS BELOW). WE RECOMMEND YOU REACHING OUT TO YOUR CARRIER TO INQUIRE ABOUT YOUR ‘OUT OF NETWORK’ BENEFITS.

PLEASE TAKE TIME TO CAREFULLY READ THROUGH ALL FINANCIAL AND CANCELLATION POLICIES. YOU WILL BE REQUIRED TO HAVE A CREDIT CARD OR DEBIT CARD ON FILE.

FINANCIAL AND CANCELATION POLICY
 

HOW TO FILE A HEALTH INSURANCE CLAIM.

**Note: If you have an insurance above that we are ‘in network’ with, we will file your claim with your insurance. You would simply be responsible for any copayment/deductible due at the time of your appointment.

For ‘out of network plans’:

AFTER YOUR VISIT YOU WILL BE PROVIDED WITH A BILLING SUMMARY WHICH YOU MAY SUBMIT TO YOUR INSURANCE PROVIDER FOR REIMBURSEMENT. WE HAVE PROVIDED SOME HELPFUL LINKS BELOW, BUT YOU MAY NEED TO REACH OUT TO YOUR SPECIFIC INSURANCE CARRIER TO DETERMINE EXACTLY WHAT FORMS NEED TO BE COMPLETED. ADDITIONALLY, IT IS YOUR RESPONSIBILITY TO KNOW IF YOU ARE ELIGIBLE FOR ‘OUT OF NETWORK’ BENEFITS.

YOUR INSURANCE POLICY IS A CONTRACT BETWEEN YOU AND YOUR INSURANCE COMPANY. YOU NEED TO VERIFY YOUR BENEFITS WITH THEM. WE ARE NOT A PARTY TO THAT CONTRACT. ANY DISPUTES REGARDING UNPAID REIMBURSEMENT TO YOU ARE YOUR RESPONSIBILITY TO HANDLE BETWEEN YOU AND YOUR INSURANCE COMPANY.

www.Reimbursify.Com is a site that will file your claim to your insurance company. The first claim is free and $2.99 for each claim thereafter.

AETNA CLAIM FORM

How to File a Health Insurance Claim