Patient Information & Forms
Texas Ear Nose & Throat Specialists, LLP wants to make your visit to our office as smooth as possible. In order to do so it is important for us to gather relevant information about you, your insurance coverage, and your reason for visiting us. This is accomplished by completing several forms and obtaining your signature.
New patients should arrive 15-30 minutes prior to their scheduled appointment time with the completed new patient paperwork. Please be prepared to provide your driver’s license, insurance cards, and any required insurance referral or authorization. Please bring a list of your current medications and any records applicable to your office visit including recent CT scans, labs, x-rays or sonograms.
Delays are sometimes unavoidable. We strive to see patients promptly as scheduled, but emergencies are inevitable and can cause unplanned delays.
- Admar (BCE)
- BCBS/Blue ChoicePPO/POS – www.bcbstx.com
- HMO Blue of Texas
- BCBS – www.bcbstx.com
- Blue Link
- Beech Street – www.beechstreet.com
- Benefit Planners – www.benplan.com
- CCN – www.ccnusa.com
- Central States – www.centralstates.org
- Choice Care Humana PPO – www.humana.com
- Cigna/PPO/EPO www.cignaforhcp.com
- Cigna (Healthsource) – www.cignaforhcp.com
- Cigna HMO/POS MedSolutions – www.cignaforhcp.com
- Cigna Select – www.cignaforhcp.com
- Continental General – www.healthplan.com
- Galaxy (Managed Care Inc.)
- Gallagher Benefits
- GEHA – www.geha.com
- Great West Health – www.greatwesthealthcare.com
- HealthSmart/ NTHN – www.healthsmart.net
- Motorola PPO
- National Health Care (was USC)
- PPONext – www.pponext.com
- Pacificare/Secure Horizons – www.pacificare.com
- ProAmerica (BCE)
- United Healthcare – www.unitedhealthcareonline.com
- UP&UP-America’s Health Plan (BCE)
New Patient Forms
New Patient enrollment packets are available for you to print. Please complete all pages in the packet and bring them with you to your appointment.