Insurance Plans and Networks Accepted by TriValley

As noted elsewhere, acceptance of networks and insurance plans may change. TriValley Primary Care continues to validate the insurance and payment plans it will accept. Always check with with your insurance plan that your TriValley provider is an enrolled provider. Note: Medicare beneficiaries are assured that all TriValley providers are participating providers with “original” Medicare.

TriValley Primary Care – Participating Insurance Companies

INSURANCE NETWORKS

TVPC participates with any insurance cards with these logos, except as noted as of 4/28/2017

TIMELY FILING
InterGroup Not all insurance cards will have the InterGroup emblem, check your list of InterGroup insurances. Beech Street is part of InterGroup
OneNet PPO All plans, except Workers Comp

INSURANCE PLANS

EXCEPTIONS/NOTES

TIMELY FILING
Aetna Aetna HMO- must be on capitation list. PEBTF-PPO Only 120 days
AmeriHealth Admin & InterCounty All Plans 1 year
AmeriHealth HMO & PPO AmeriHealth HMO – must be on Keystone capitation list 1 year
Benefit Concepts, Inc.  (BCI) Must be paired with BC/BS logo 1 year
Blue Cross/Blue Shield or Blue Shield Front of card should be either: empty suitcase, suitcase w/PPO. Or back of card should specify that claims are submitted locally. 1 year
Capital Blue Cross (Not participating, but will submit claims locally through Highmark under the Blue Card program) 1 year
Personal Choice
Cigna / Great West All Plans EXCEPT Cigna Medicare Access 90 days
Geisinger Health Plan St Lukes Plans Only
Health America, Health Assurance, Coventry Health HMO Plans- pt must be assigned to TVPC Office #308313. Includes First health Network. Does NOT include Advantra enrollees. 1 year
Independence Administrators 1 year
Keystone Health Plan East Must be on capitation list. 1 year
Keystone First Must be on capitation list. 6 months
Medical Assistance Must be “Fee for service” 180 days
Medicare Original Medicare and Railroad Medicare, Part B coverage 1 year
Medicare Advantage Plans Keystone 65, Personal Choice 65, Aetna (Choice POS, Aetna MCR Gold POS, Standard & Premier), BS Freedom Blue PFFS, BS Select Advantage PFFS, Keystone Focus, UHC MCR ADV PPO ONLY. DO NOT ACCEPT:Evercare, Sterling Option 1, BRAVO, Geisinger Gold or any others
Medigap & Medicare Supplemental Policies All Medigap plans and any Medicare supplemental plans that pay TVPC directly (most do) are accepted.
Premier Blue Shield 1 year
TRICARE TVPC providers are non-network providers. They will accept assignment from TRICARE. No TRICARE prime HMO 1 year
United Healthcare Most commercial plans. Also Oxford Choice Plus Only DO NOT ACCEPT: Compass, SecureHorizons Medicare, Evercare, Community Plan, Medicare/CHIP; PA Benefit Medicaid, TRICARE benefit and other govt plans
Veterans Administration We submit and balance bill the patients but do not participate 1 year
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