• Aston
• LabCorp
• Clinical Pathology Laboratories (CPL)
• Quest
  
  Note:  Providers may perform any lab services they are CLIA certified to perform in their office.

• Algur H. Meadows  Diagnostic Imaging Center
• Aston Radiology
• Mary Nell & Ralph B. Rogers MRI Center
  

However, NTHN does not recognize "Meadows" or "Rogers" as a participating facility. Authorization must be obtained by using the Radiologist’s name.

• Children’s Medical Center
• St. Paul Medical Center
• Zale Lipshy University Hospital
• Parkland Health and Hospital System
• UT Southwestern Clinical Procedure Center (ASC)
• Moncrief Radiation Oncology Center (MROC) 

• Refer to the HealthSmart/NTHN Product Description

Refer to the HealthSmart/NTHN Precertification List for a list of requirements. However, precertification requirements may vary by employer group.

Obtain Home Health Care/Home Infusion Therapy authorization if necessary.  Home Health Care can be provided by UT Southwestern Zale Lipshy Home Health.  This Home Health group has a contract with Healthsmart/NTHN and should be utilized whenever possible.  For referrals and questions regarding Zale Lipshy Home Health Services, please contact 214-590-9600.

Effective 10/01/03, HealthSmart members will utilize the NTHN network.

• ID Cards should reflect "HealthSmart", "North Texas Healthcare Network", "NTHN" and/or NTHN or HealthSmart Logo on the front of the ID card.
• ID cards will vary in appearance as the cards are produced by different companies.
• Effective 10/01/03, HealthSmart members will utilize the NTHN network.

• Members are responsible for any copayment, coinsurance and/or deductible required by the plan. The member ID card should indicate the copayment required.
  
• A copayment is collected at the time of the office visit. Any applicable deductible or coinsurance may also be collected at this time.
  
• You will want to verify copayments, coinsurance and deductibles when you call the payor to verify benefits.
  
• If the ID card does not have the amount shown for the copayment, coinsurance, and/or deductible, you should obtain prior to services so you can collect the appropriate amount or you may choose to bill the responsible party.
  
• The provider may choose to bill the patient for any deductible/coinsurance due by the member at the time of service or upon receipt of the Explanation of Benefits (EOB).
  
• As a reminder, if you do choose to collect the deductible or coinsurance up front, charges exceeding the allowable rate must be refunded to the patient.

• The subscriber’s employer name is required to ensure the processing of the claim by the appropriate Payor.
• Claims should be filed within 95 days from date of service.
• Claims should be submitted on a HCFA 1500 claim form- NO Superbills.

• HealthSmart/NTHN reprices claims and forwards claims
  to the Payor.
• Clean paper claims should be processed within 45 days
  of receipt by the Payor. Clean electronic claims should
  be processed within 30 days of receipt by the payor.