Billing Information

Medical Insurance Plans Accepted

Children's Health accepts most major insurance plans. This information is subject to change at any time without notice. Please contact your insurance plan directly to confirm participation status, as not all hospitals may be contracted due to location or services provided.

View a list of contracted insurance plans for Children's Health to determine if we are in-network with your insurance company. Please choose your preferred language below to access the list of available plans.

Contracted Insurance Plans: ( English (PDF) | Spanish (PDF) )

Billing Terms Explained

Term	Definition
Deductible	Amount of money patients pay each year to cover medical care services before the insurance plan starts to pay.
Coinsurance	Percentage of the cost of a procedure or visit that must be paid after you have met your deductible.
Copay (Copayment)	A fixed amount or flat fee owed for specific type of service. The amount may vary depending on coverage benefits.
Out-of-Pocket Maximum	The most you have to pay for insured services in a year. May include your deductible.
Guarantor account	Global, or umbrella, account numbering scheme for all the children in a family. This allows us to pool, monitor, and provide a family’s financial information for all accounts together on a monthly statement.
In-network or Out-of-network	Whether the doctors or facilities are covered or not covered by your insurance plan. Physicians negotiate their own insurance contracts. Some physicians could be out-of-network for your insurance even though Children’s Medical Center is in-network.
Medical record account	Internal numbering scheme of the medical chart for you or your dependent. This number does not change with each visit to Children’s Medical Center.
New Account	Generated virtually each time you have services at Children’s Medical Center.
Outpatient facility, day surgery, specialty clinic, ambulatory	Visits that do not require an overnight stay. Compared to a regular doctor’s office visit, visits to our outpatient facility are generally considered a specialty-type visit by insurance carriers. Insurance carriers usually have a more expensive co-payment for this type of service. The doctors who treat children in the hospital are highly trained to be the best equipped to handle complex care. If you or your dependent is admitted to an inpatient bed for a short stay, the physician may order "observation" services instead of "inpatient" services, based on the patient's medical condition. If that is the case, these services will be billed as "outpatient" services instead of as “inpatient” and will be subject to your plan's outpatient deductible requirements.
Payment Plans	Available for anyone needing to discuss payment options outside of the standard due dates. When a bill is your responsibility, you have 90 days to pay it. There is a notification on your bill under each account listed that notes how long the account has been due.
Physician Bill	The bill you will receive from your treating physician. Physicians are not employed by Children’s Health. The physicians bill for professional fees separately from Children’s. If you receive a bill for professional physician services, please contact the phone number on the bill for assistance.
Plan Administrator	Helps you navigate the world of payments and answer additional questions.
Premium	Monthly fee you pay to your insurance company to have coverage. This amount is not necessarily going toward anything, but ensures you are covered. Generally, if the deductible is higher, the premium will be lower.
Tertiary care hospital	A hospital able to receive specific patients and one which has a trained staff in a specialized area. Children’s is the only academic healthcare facility in North Texas dedicated exclusively to the comprehensive care of children from birth to age 18. Since we specialize in pediatrics, our charges may be higher than those in your physician’s office or at a community hospital. However, our charges are comparable to those in other pediatric specialty facilities.
Treating physician	Physician who provides, or has provided, medical treatment or an evaluation to you or your dependent. When medical treatment or an evaluation is provided, the physician establishes a relationship with you. At this point, the government considers the medical provider as the treating physician. This is important, because Children’s is a separate legal entity from the treating physician. Some physicians could be out-of-network for your insurance even though Children’s is in-network. You may also receive a separate physician’s bill from you Children’s bill. If you receive a bill for professional physician services, please contact the phone number on the bill for assistance.

Billing Process

During the visit, an estimate can be requested to know how much you will be responsible to pay. Other services may be received during your visit.

For patients with insurance, a claim will be sent to your health plan. Upon receipt, the payer will send an Explanation of Benefits (EOB). This document will show the total of charges from your visit, how much your plan covered and how much you are responsible for.

Any balance due from uninsured or insured patients, will be sent out in a statement.

If you have any questions, please contact us online, by phone or mail.

Do I qualify for Financial Assistance?

You or your dependent may qualify for financial assistance based on your household income.