Download Forms

We have provided the following forms for our patients.  You can quickly and conveniently download these office forms.  Please bring your completed forms into the office at the time of your visit.

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Insurance Information

Heart of Texas Pediatrics participates in the following insurance plans:

Accountable Health Plan

Aetna

Affiliated Healthcare

BCBS Blue Choice

BCBS Par Plan

Beech Street

Blue Bell Creameries

Brazos Valley Network

ChoiceCare Network (HMO)

Cigna-BVN

Definity Health

First Care/Southwest Health & Life

First Health

Galaxy Health Network

Great West Healthcare

Healthsmart

Humana PPO

Humana/Military

MCD/TAX ID

MCD/Healthsteps/TAXID

MCR DME

MedCorp Southwest

Multispan/BCE Emergis/Admar

PHCS

PPO Next

Principal Life Ins

Pronet/Aetna/TRS (Teacher Retirement System)

Providence Health Alliance

Scott & White

Superior Health CHIP

Texas Municipal League

Texas True Choice

Tricare

Unicare

United American

United Healthcare

USA MCO PPO

Wells Cargo/Caresource

If your insurance is not on the list, please call your insurance company to see if we are a provider. We accept most insurances. Always make sure your policy covers preventive care, including well-child visits and vaccines. You are responsible for any services not covered by your insurance company.

Prescription Refills

For refills, please first contact your pharmacy first. If no refills are available, the pharmacy will send a request to our office. Refills on antibiotics generally will not be approved. An appointment will need to be scheduled. Refills on controlled substances such as ADHD medications require pick-up from the office, please contact us 24 hours in advance for such refills. We may require a recent office visit for refills on medicines for chronic conditions such as asthma and seizures.