| Payor | Contracted Products | Exclusions & Notes |
|---|---|---|
| Ambetter (Superior HealthPlan) | Essentials, Balanced, Secure | Excludes Ambetter Virtual and HMO Value products. |
| BCBSTX | MyBlue Health | Offered in Collin, Denton, Tarrant, Rockwall, and Dallas counties. |
| Payor | Contracted Products | Important Notes |
|---|---|---|
| Aetna Commercial | Choice POS II, PPO, Managed Choice, QPOS, Select | Referrals required for HMO/Select. Excludes Better Health Medicaid. |
| BCBSTX | Blue Choice PPO, Blue Essentials, Federal (FEP) | Excludes: DART Employees with HPN are Out-of-Network. |
| Cigna | HMO/POS, OAP, PPO, Cigna + Oscar | Referrals required for HMO/POS. |
| United Healthcare | Choice/Choice Plus, Options PPO, Core, NexusACO | NexusACO is Tiered; SWHR is Tier 2. Excludes Allsavers Charter plans. |
| Other Networks | HealthSmart, PHCS/Multiplan, Coventry, First Health | Verify specific plan participation in EPO products. |
| Program / Payor | Details | Notes |
|---|---|---|
| Aetna Medicare | ESA PPO | HMO and most PPO products termed as of 1/1/2025. |
| Humana Medicare | HMO (Gold Plus), PPO, WellMed | Accepts WellMed PCP assigned patients. |
| United Healthcare MA | PPO, Regional PPO, HMO | Includes HealthSelect and TRS Care networks. |
Office Visit Mandatory: Patients must be seen by Dr. Rai prior to the issuance of any referral to a specialist.
Reason for Visit: A clinical evaluation is required to document the medical reason for the visit and ensure necessary diagnostics are prepared for the specialist.
I authorize Hardeep Rai, MD, P.A. to release to my insurance carrier any information necessary to determine benefits. I authorize the payment of medical benefits directly to the physician.
I understand that I am ultimately responsible for all services and charges, whether covered by insurance or not.