Understanding Your Insurance & Billing
We accept most major insurance plans and provide clear, upfront billing practices. Find everything you need to understand your coverage, payments, and how we handle claims.
We Accept Most Major Insurances
We work with a wide range of insurance providers to ensure you get the care you need.
No Insurance? No Problem.
We welcome self-pay and cash-pay patients. Contact us for competitive pricing information.
How to Verify Coverage
Follow these steps to confirm your insurance covers visits to Advocate Primary Care.
Call Your Insurance Company
Ask if "Advocate Primary Care" is in-network for your specific plan. The number is usually on the back of your insurance card.
Have Your Member ID Ready
Your member ID and group number help the representative quickly look up your benefits.
Contact Us for Assistance
Call us at (972) 382-5761 and we'll help confirm what we can about your coverage.
Please note: We cannot guarantee benefits accuracy. Only your insurance company can confirm the specifics of your coverage, including copays, deductibles, and coinsurance amounts.
Referrals & Prior Authorizations
Understanding when referrals are needed and how we handle authorizations.
HMO Plans
HMO plans typically require a referral from your primary care provider before seeing a specialist. We can help coordinate these referrals when needed.
PPO Plans
PPO plans generally do not require referrals to see specialists. You have more flexibility to see providers both in and out of network.
Turnaround Time
Referrals are typically processed within 2-3 business days. Prior authorizations may take longer depending on your insurance company's requirements.
What to Bring
Bring your insurance card and PCP assignment letter (if applicable). This helps us verify your coverage and process any needed referrals efficiently.
Billing Basics
Understanding copays, deductibles, and coinsurance helps you know what to expect financially.
Copay
A fixed amount you pay at the time of your visit. Your copay amount depends on your specific insurance plan and is typically collected when you check in.
Deductible
The amount you pay out-of-pocket before your insurance starts covering costs. Deductibles reset annually, usually at the start of each calendar year.
Coinsurance
The percentage of costs you pay after meeting your deductible. For example, if your coinsurance is 20%, you pay 20% of covered services while insurance covers 80%.
What If Insurance Denies a Claim?
Sometimes claims are denied, but there are steps we can take together to resolve the issue.
Review Your Explanation of Benefits (EOB)
Your insurance company will send you an EOB explaining why the claim was denied. Common reasons include missing information, coding errors, or services not covered under your plan.
Contact Our Office
If you believe there's an error, call us at (972) 382-5761. We'll review the claim and re-submit with corrected information if needed.
Appeal Process
If the denial stands after correction, you have the right to appeal. We can assist with providing medical documentation to support your appeal.
Be patient: The claims and appeals process can take time. We recommend keeping copies of all correspondence with your insurance company and our office.
Portal & Payments
Manage your account, view statements, and make payments online.
Patient Portal
Access your medical records, view test results, request refills, and message your care team securely.
Pay Your Bill
View your statements and make secure payments online through Healow Pay. We accept all major credit cards and HSA/FSA cards.
Have billing questions? Call us at (972) 382-5761
Labs & Imaging Billing
Understanding how laboratory and imaging services are billed.
Separate Billing for Labs & Imaging
- Laboratory tests and imaging studies are often processed through partner facilities that bill your insurance directly.
- You may receive a separate statement from the lab or imaging center in addition to any charges from our office.
- If you have questions about a lab or imaging bill, contact the facility listed on your statement.
Learn more: Visit our New Patients page for additional information about what to expect during your visit.