
Patient Resources

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OFFICE POLICIES
Notice of Privacy Practices (PDF)
PATIENT FORMS
Authorization for Release of Medical Information (PDF)
Insurance and Fees
Our clinic accepts most insurance plans, however you should always check with your provider to verify plan and product coverage as plans change frequently.
*Medicaid participation is optional and varies amongst West Texas Health Providers – please verify participation prior to your visit.
Payment Options
We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.
Card-on-File
We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.
At check-in we will:
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scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card
After your insurance has paid their portion, we will:
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notify you via email of the balance owed
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charge the balance owed to your card on file
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email a receipt for the charge
Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).
Fees
ADDITIONAL RESOURCES
Avoiding Surprises in Your Medical Bills
Avoiding Surprises in Your Medical Bills (Spanish)
Understanding Healthcare Prices: A Consumer Guide
Appointments
Missed Appointments
$50
Missed Physical
$100
Late Cancellation
$50
Missed Pediatric Appointment
$50
No Show
$50
Missed Procedure
$200
Out of Network
New Patients
Total Charge or Minimum $200 Deposit
Established Patients
Total Charge or Minimum $150 Deposit
Self Pay
New Patients
Total Charge or Minimum $200 Deposit
Established Patients
Total Charge or Minimum $150 Deposit
Procedures
Total Charge or Minimum $200 Deposit