Insurance & Fees

Insurance & Fees

We are on most major insurance plans (HMO and PPO) and on certain Medicaid plans. It would be best for you to call your insurance first to ensure that Dr. Burton is in network, but feel free to call us if you have questions as this often changes.

Please have your insurance card ready and notify us of any insurance changes.

Please understand that each plan is different and you need to be aware of Preferred Lab status (such as Lab Corp or Quest).

Most patients will have labs and x-rays done after their first visit.

The following is the list of insurances with which we participate. This will be updated from time to time as needed:

  • Aetna (No HMO Exchange, No ACO, No QHP, No TRS)
  • Aetna First Health (Must say Aetna on card)
  • Aetna Medicaid
  • AmeriGroup Medicaid (please wait for an effective date)
  • Beech Street
  • Blue Cross Blue Shield, PPO, POS, HMO Blue
  • Blue Premier HMO Network
  • Choice Care (Humana)
  • Cigna HMO, PPO, Flex, POS, Open Access, Select Network (No Cigna Focus)
  • Galaxy Health Network PPO
  • Great-West Healthcare (Thru Cigna)
  • HealthSmart Preferred Care
  • Humana One Individual Plans (Thru Choice Care)
  • Interplan Health Group (Accountable, Health Payers)
  • Medicaid
  • MultiPlan (No Discount Cards)
  • Private Health Care Systems (PPO only, thru MultiPlan)
  • Scott and White Health Plan, Commercial, PPO
  • Texas True Choice PPO/POS
  • Three Rivers Provider Network
  • United Healthcare (No Exchange plans, No Medicaid, No Community Plan)

*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.

Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.

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:

  • 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:

  • notify you via email of the balance owed
  • charge the balance owed to your card on file
  • 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

No Shows
Late Cancellation $25
No-Show $25
Missed Procedure $200
Out-Of-Network/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

 

Additional Resources

Avoiding Surprises in Your Medical Bills

Avoiding Surprises in Your Medical Bills (Spanish)

Understanding Healthcare Prices: A Consumer Guide

Understanding Healthcare Prices: A Consumer Guide (Spanish)

Planning For a Medical Procedure