Mon - Thr : 9:00AM to 5:00PM | Fri : 8:00AM to 1:00 PM West Jordan
Phone: (801) 569-2696 | Fax: (801) 528-6558

Insurance

Health insurance can be a confusing issue. We’ve provided some information to help you better understand your benefits. Keep in mind, not all insurance plans provide the same benefits. While some services and products may be covered by one insurance plan, they may be excluded by another. Please review this information or contact your specific health insurance provider for more information about your specific plan.

Types of Health Plans

  • PPO (Preferred Provider Organization) – This type of insurance has contracts with physicians they would “prefer” you see, essentially creating an “in-network” group of doctors and an “out-of-network” group of doctors. The deductible, co-pay, and co-insurnace can be different for in-network and out-of-network doctors. However, a PPO gives patients a choice and those benefits cannot be denied by your insurance company even if you go out of network.
  • HMO (Health Maintenance Organization) – an HMO is a closed-network of health care providers. In other words, there are no benefits for you to see an out-of-network doctor. Unless you see one of the in-network providers, the insurance will not cover any of the services or products you receive.

Basics of Insurance Terms

  • Co-pay – A payment made by a patient at the time a service or product is provided. The amount is determined by your insurance plan and is required for every visit. There are exceptions to this rule when surgical procedures have been performed. Minor procedures carry a 10-day global period in which copays are not required. Other surgical procedures have a 90-day global period.
  • Deductible – An amount you must pay before your insurance begins paying their portion of the fees. 
  • Co-insurance – The percentage of coverage for services or products your insurance will cover after a deductible has been met. For example, an 80/20 plan means the insurance pays 80% of the costs while a patient pays 20% after your deducible has been met.
  • Out-of-Pocket Max – The maximum amount of money your insurance will require yo to pay. After you have met this amount, the insurance generally pays for all covered services and products at 100%. This is calculated by combining a deductible and the patient percentage of the co-insurance.

We Accept Most Insurance Plans

IN NETWORK INSURANCE PLANS

  • Administrators West
  • Aetna
  • Altius
  • American Medical Security
  • A-Plus Benefits, Inc.
  • Ascent Management, Inc.
  • ASG Teamsters
  • Associated Food Stores
  • Beech Street
  • Benesight
  • BlueCross and BlueShield
  • Bricklayers & Allied Crafts Workers No 1
  • CCN
  • CHAMPUS
  • CHIP (Children’s Health Insurance Program)
  • ChoiceCare (Humana)
  • ChoiceNet/InterCare Health Systems (CNIC)
  • Cigna
  • Codale Electric
  • Coventry
  • CBSA (Corporate Benefit Services)
  • DMBA
  • DMERC/DMEPOS
  • Educators Mutual Insurance (EMI)
  • Eighth District Electrical Benefit
  • Everest Administrators, Inc.
  • FirstHealth
  • Freedom Life Insurance Co. (AscentManagement)
  • GEHA (Government Employees Health Association)
  • GenPak
  • GreatWest
  • Health Utah
  • HNA (Health Networks of America)
  • Humana
  • IBEW/Western Utilities Health & Welfare
  • IHC (see Select Health)
  • Iron Workers Union
  • Intermountain Untied Food & Commercial
  • JAS
  • Mail Handler Benefit Plan
  • Managed Care Administrators, Inc.
  • Mark Travel (aka LaMacchia)
  • MBA Benefit Administrators, Inc.
  • Medicaid
    • Traditional Utah Medicaid
    • Molina
    • CHIP
    • Community Care (Select Health / IHC)
  • Medicare Advantage
  • Medicare
  • Medicare Complete
  • Molina
  • Multi-Plan
  • National Foundation life Ins. Co. (Ascent Management)
  • Painters Association Trades Health & Welfare
  • Parker Hannifin
  • PEHP
  • PHCS (Private Healthcare Systems)
  • Questar Corporation
  • Railroad Medicare
  • Regence (BCBS)
  • Sapp Bros.
  • Select Health (IHC)
    • Community Care
    • Select: Care
    • Select: Care +
    • Select: Choice
  • Sierra Spectrum
  • Sinclair Oil Corporation
  • Tall Tree Administrators
  • Tricare
  • United Health Care
  • United Health Integrated Services
  • Utah AGC Teamsters Welfare Trust
  • Utah-Idaho Teamsters Health & Welfare Trust
  • Utah-Idaho Teamsters Security Fund
  • Utah Laborers Health & Welfare Trust
  • Utah Pipe Trades Welfare & Trust Fund
  • Utah Sheet Metal Welfare Fund
  • Weathershield
  • Western Mutual
  • Williams International
  • WMI Mutual Insurance Company
  • Wise Provider Networks
  • Workers Compensation
  • Workers & Food Industry Health Fund

Health insurance is form of payment for products and services received in our office. It is important to remember that a health insurance policy is a contract between you and your insurance company. We do not set the terms or conditions of that insurance policy. Consequently, it is important for you to be informed about your benefits and financial responsibilities per the terms of your insurance. We recommend you contact your health insurance company to understand the terms and conditions of your policy. For more information about our office financial policy, please read here.

OUT-OF-NETWORK INSURANCE PLANS

  • PCN (Primary Care Network)
  • Select Health
    • Select: Advantage
    • Select: Med
    • Select: Med + (We are out of network with this plan, but it does offer out-of-network benefits. Contact our office and we can work with you and the insurance on the charges)
    • Select: Value
  • University of Utah Health Plans