Navigating Your Insurance Coverage at Montgomery Gynecology

Insurances AcceptedComprehensive Insurance Support

At Montgomery Gynecology, we understand the importance of straightforward and accessible healthcare financing. We proudly partner with most major insurance providers, ensuring that your gynecological care is covered. Whether you're visiting for an annual well woman visit, seeking reproductive choices advice, or require in-office procedures or robotic gyn surgery, we're here to make the process as seamless as possible.

Verify Your Coverage

To ensure that your visit is covered, we recommend contacting our office or your insurance company directly. Our team is adept at navigating the complexities of insurance plans, specializing in areas such as menopause management and adolescent gynecology, among other services. This proactive approach helps prevent any unexpected costs and streamlines your care experience.

Understanding Your Benefits

Insurance policies can be intricate, with coverage for services like well visits, sick visits, and emergency care varying significantly. We encourage you to become familiar with your plan's specifics, including office co-pays, deductibles, and eligible services, to fully understand your benefits and responsibilities.

Our Commitment to You

Montgomery Gynecology is committed to working closely with both our patients and their insurance providers. From assisting with claim forms to ensuring you receive the maximum benefits entitled to you, our goal is to minimize your financial concerns while maximizing your care quality.

Sports Physicals FAQs

What is a sports physical?

Every child or teen in Texas who wants to play in a sport or engage in other school activities like cheerleading must have a sports physical or a preparticipation physical examination. They also need a sports physical to clear them to return to their activities if they suffer an injury or become ill during the season.

The purpose of a sports physical is to be sure your child can safely participate in sports. Suddenly starting high-intensity workouts and engaging in competitive sports can quickly aggravate a pre-existing problem or lead to a preventable injury when an exam discovers potential problems.

Although a sports physical may find a problem that prevents your child from participating, in most cases, the examination results guide decisions. The exam reveals problems that Eastside Children’s Clinic can treat before your child starts a sport, and shows if your child needs extra training to get in shape to safely participate.
Why is a child’s medical history important?
Children and parents use a medical history form to provide information about:
- Chronic illnesses such as asthma, diabetes, or epilepsy
- Hospitalizations or surgeries
- Past injuries such as concussions, sprains, or fractures
- Problems with dizziness, chest pain, or breathing during exercise
- Medications and supplements
- Allergies
- Family history of serious illnesses
A complete medical history helps your doctor determine if your child has a condition that sports activities might aggravate.
How is a sports physical exam different from an annual checkup?

The physical exam for sports participation has a different focus than a wellness exam. During a sports physical, a pediatrician at Eastside Children’s Clinic evaluates your child’s musculoskeletal health, assessing bones, muscles, and joints for flexibility, strength, and signs of overuse injuries or stress.

Their doctor carefully examines concerns that could reappear during sports activities, such as previous fractures, sprains, concussions, skin infections, a past history of pain or dizziness, and chronic health conditions.

An existing condition doesn’t always prevent a child from playing sports, but it may mean that they need help to accommodate their activity.

If your child has asthma, for example, they may need a different inhaler or need to learn to use their inhaler shortly before they start their warmups to prevent an exercise-induced asthma attack.

If your child needs any type of physical, call our office or schedule an appointment online.

Benefit: Amount of money your insurance plan pays for the health care services you receive.
Billed Charges: Billed charges mean the total charges billed by a Physician’s office. It shows the gross billed price of services and does not represent the amount paid by the insurance.
Claim: This is another word for a health care bill. It is sent to your insurance plan from doctor’s office after service is provided and it list out all of the services you received.
Coinsurance: Some insurance plans cover only a percentage of the cost of your care. For example, if your plan has 10% coinsurance for a service that cost $50, your insurance plan will pay $45 dollars and you will pay $5.
Copay: A fixed amount paid by a patient for a covered service. Some insurance plans cover certain types of care at a set rate- also called a copay. For example your plan may charge $25 per doctor visit or $50 dollars for each day a patient is an inpatient in the hospital.
Deductible: A set amount you have to pay every year before your health insurance company starts paying. For example, if your health care service costs $5,000 and your plans annual deductible is $3,000, once you have paid that $3,000, your insurance plan will pay all or part of the remaining $2,000 (depending on what type of coverage your plan has). Most insurance plans have to cover some services (like annual well visits), regardless if you have met your annual deductible or not. PLEASE NOTE: Patients who come for annual well women visits and discuss issues not considered covered under the annual may be subject to other outstanding charges by the payor.
Fee Schedule: List of charges for health care services. Insurance plans publish fee schedule lists representing the maximum charges (or prices) they will reimburse for the same services. In many instances, the reimbursement amount offered by insurance plans is less than what is charged by health care providers.
Premium: The amount that must be paid to the insurance plan to maintain the desired insurance plan coverage.

Insurance Terms Explained

Navigating health insurance terminology can be daunting. Here's a brief overview of key terms to help you understand your policy better:

● Benefit: The payment made by your insurance for covered services.

● Billed Charges: The total cost billed by our office, not necessarily what your insurance pays.

● Claim: The bill sent to your insurance after receiving our services.

● Coinsurance: Your share of the costs of a covered healthcare service.

● Copay: A fixed amount you pay for a covered healthcare service.

● Deductible: The amount you pay for covered health services before your insurance plan starts to pay.

● Fee Schedule: A list of the maximum amounts your insurer will reimburse for healthcare services.

Next Steps

For personalized assistance with your insurance queries or to verify coverage for specific services like abnormal bleeding treatment or adolescent gynecology, please contact our office at 215-444-3411. Our knowledgeable staff is here to guide you through the insurance process, ensuring you have all the information needed for your care at Montgomery Gynecology.