Insurances Accepted
Southwest Medical Associates is a provider for most major insurance plans. However, it is in your best interest to check your insurance providers list of participating physicians to be sure your plan allows you to be seen at our office. Please review with your insurance customer service representative (or insurance provider) the rules and limitations on coverage and reimbursement. Also check with your insurance company for any special instructions so that your insurance company will pay for services you receive at Southwest Medical Associates. Your insurance company can tell you about any co-pays or deductibles for which you will be responsible. Knowing this information beforehand will help keep you from running into problems once you arrive. If you don't follow your insurance company's instructions, you may have to pay additional money out-of-pocket for the office visit.
Each insurer has specific requirements that must be met prior to consultation and treatment. Authorizations or referrals may be required to receive services from one of our specialists. Insurance is an important part of your healthcare. Verifying coverage allows you to focus on your treatment and a hassle-free recovery. Your insurance carrier expects us to verify coverage prior to any service we provide to you. In order to comply with their request we need you to bring your insurance card to every appointment. As a service, we will complete and submit your insurance forms to your carrier. Below is a list of the plans with which we currently contract.
Presbyterian Health Plan www.phs.org
The following are some of the products offered by Presbyterian Health Plan.
- HMO
- Mutual of Omaha
- Preferred Provider Organization (PPO) Plans
- Presbyterian Salud
- Senior Care
- Presbyterian Select Network (PHP-SPN)
Cigna www.cigna.com
Cigna offers the following health benefit plans In New Mexico.
Network Plans:
- Network
- FlexCare Exclusive Provider Program (EPP)
Point-of-Service Plans:
- Point of Service
- FlexCare Designated Provider Program (DPP)
Lovelace www.lovelacehealthplan.com
- University of New Mexico Custom Care Plan 2005
- New Mexico Retiree Health Care Authority 2004/2005 Benefit Summary
- Federal Employees
- City of Albuquerque, effective 7/1/2005
- Wal-Mart
Medicarewww.trailblazerhealth.com
Multiplan www.multiplan.com
- (formerly known as BCE Emergis)
- AHC
- ProAmerica
- Up & Up
- HN Health Network
- bps Healthcare
- MED NETWORK
- FORMOST
- Admar Corporation
- WELLMARK
United Healthcare www.unitedhealthcare.com
Small Employer Groups (2-50 employees)
- Options PPO
- Managed Indemnity
Medium-Sized Employer Groups (51-5000 employees)
- Choice
- Choice Plus
- Select Plus
- Options PPO
- Managed Indemnity
Large Employer Groups (over 5,000 employees)
- Choice
- Choice Plus
- Select Plus
- Options PPO
- Managed Indemnity
One Health Plan (GreatWest) www.greatwesthealthcare.com
- Great-West Healthcare Consumer AdvantageSM
- Preferred Provider Organization (PPO)
- Health Maintenance Organization (HMO)
- Point-of-Service (POS)
- Open Access
HealthSmart www.healthsmart.net
- Point of Service Plan (POS)
- Gated EPO (GEPO)
- DFW GEPO
BCBS www.bcbsnm.com
- HMO NM
- PPO
- POS
Under age 65:
- BlueEdge Individual HAS
- BlueChoice
- BlueChoice Plus
Coverage for Groups
BCBSNM also has insurance plans for employer groups of two or more.
- BlueEdge HCA
- BlueEdge HSA for Groups
- Blue PPO
- Blue PPO Plus
- BlueNet
- Blue Point-of-Service
- HMO Blue
Beechstreet www.beechstreet.com
- PPO
Aetna www.aetna.com
Albuquerque
- Aetna Choice™ POS II
- Elect Choice® EPO
- Aetna Open Access™ Elect Choice® EPO
- Managed Choice® POS
- Aetna Open Access™ Managed Choice® POS
- Open Choice®
- Aetna SelectSM
- Open Access Aetna SelectSM
Indemnity Plan
- Traditional Choice® Indemnity Plan
Medicaid PHP Salud www.phs.org
New Mexico Medicaid www.hsd.state.nm.us/mad/
Do we file your insurance?
We are happy to process the contracted primary insurance forms for you as long as you have provided us with the appropriate insurance information. Co-payments, co-insurance and deductibles are all due at the time services are delivered. We also expect payment promptly if you receive a bill from our office for balances that may be due. Please feel free to discuss any questions you may have about billing with the business office staff.
What if my insurance company isn't on the contracted list?
We will ask you to pay for services at the time they are delivered.
Forms of Payment
We accept Cash, Checks, MasterCard, Visa and Discover