Become A Patient

Thank you for seeking to make Nuestra Clinica Del Valle CHC your medical home. To become a member of NCDV the individual seeking enrollment would need to register to become a member. To ensure your registration process is completed and expedited efficiently, following is the information you need to prepare for the visit.

 

Someone with Private Insurance, Medicare, Medicaid, County or CHIP:

Enrollee would need to bring the Insurance Card and Picture ID. If you do not have a current insurance card, you can provide us with information on insurance company you are enrolled with so that we can look up information on the website regarding your benefits and member number or you can bring a letter from your insurance company that contains information about your medical coverage and member number.

To take advantage of services not covered by the enrollee’s insurance plan such as dental services, enrollee will need to apply for discounts with NCDV by completing an application for services. NCDV uses a sliding fee scale set using federal government guidelines based on family annual gross income and family size. To complete the process enrollee would need to complete application form and provide proof of income, proof of utility showing that he/she resides in Hidalgo or Starr Counties, and a picture ID.

Someone with no insurance applying for Self Pay-Private Pay:

Enrollee that does not have any source of insurance coverage, either private or public, and wish to enroll as member of NCDV is required to bring one document for proof of identification, proof of residency, and proof of income from any of the options listed for each requirement.

Proof of Identification:

For Adults:

One source of identification is required with a picture ID

Current Driver’s License, TX Identification card, Legal Resident Documents, Passport

If no picture ID bring 2 of the following:

Birth Certificate, Social Security Card, Voter Registration Card, School Record/ID, Marriage License, Selective Service Card, etc.

For Children:

  1. Birth certificate
  2. Verification of Birth Facts from Hospital
  3. Social Security card (if applicable)

Proof of income (as applicable, one source as it applies to enrollee):

Earned income

If employed:

  1. Income Tax Return
  2. W2 Form
  3. Copy of most recent paycheck stubs (one month total)
  4. Statement from employer w/company’s information
  5. Notarized Statement if paid cash (document of last resort)

If self-employed:

  1. 1040 Income Tax forms (complete)
  2. Notarized Statement if paid cash (document of last resort)

Unearned income

If not employed:

  1. Recent TANF letter from Texas Dept. of Human Services
  2. Social Security Administration and/or Social Security Supplement
  3. Child support award letter from Attorney General
  4. Retirement Pension award letter, Veteran’s pension letter,
  5. Unemployment award letter from Texas Workforce Commission
  6. Notarized Statement Letter of Support (document of last resort, must contain monthly amount received and source providing support)

*Total income is required for the application process. Subsequently, if enrollee receives both earned and unearned income, both proofs would be required and combined to count towards the annual income.

Proof of Residency:

  1. Utility bill Electricity, telephone bill, gas bill, city utility, etc. (must show address)
  2. Lease from dwelling (house, apt. etc.) or Letter from Landlord if renting without a lease.
  3. If leaving with someone else: notarized letter include address where enrollee resides

Eligibility information should be updated every year or whenever there are changes in household size, household income or if someone in your household obtains or loses medical coverage or employment.

If the eligibility information is not updated and/or completed within deadline the account will be charged 100% for services provided until required documentation is obtained by NCDV Personnel. Enrollee will not be eligible to receive discounts until all required documentation is on file.

It is to the member’s advantage to bring insurance coverage information as soon as it is obtained to avoid paying unnecessarily for a service covered by the newly acquired plan. NCDV will refund patient any payment made for services covered retroactively when patient brings information immediately when coverage is obtained and within filing deadlines. If you have any questions or need clarification you may contact any of NCDV offices and speak with the Registration Clerk.