Insurance, Payment, Fees, Credits and Refunds

The patient related financial policies of TriValley Primary Care are provided via this page. Please explore these topics at your convenience. Please note that the TVPC FAQs page has related topics which you are invited to review.

Financial Policy:

Payment Policy: It is the policy of TriValley Primary Care to require payment in full on the day of service. This includes health plan co-payments, co-insurances, deductibles, and charges for non-covered services.

If an insurance claim is processed, payment is due within thirty (30) days following notice that: (1) insurer has denied payment; or, (2) insurer has not paid within 60 days of the last claim submitted; or (3) there is a balance remaining after insurance payment, except as limited by law or contract.

Financial Topics

The following topics are all related to financial matters. Please click on the topic of your choice. Navigation Note: After reviewing a topic, you may return here by clicking the <Back to Financial Topics> link or scroll up/page up until you return here.

Forms of Payment:

TriValley Primary Care accepts cash or checks; and processes payments via Star, MasterCard, VISA, and Discover (Novus) cards. Payment may be made at your TriValley office or online via this website (see Home page -> Popular Features section -> Pay a Bill). Also, if there is a balance after insurance payment, you will receive a statement in the mail showing the amount due from you. The statement has an addressed envelope and a billing stub which you can mail in with your payment.

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Show Insurance Card Each Visit:

The U.S. Federal Trade Commission has determined that a medical practice’s acceptance of insurance is, in effect, an extension of credit and falls under its authority to regulate such trade and to protect citizens from fraud and identity theft. For this reason and to follow good business practices, patients must show all current health insurance cards at EACH VISIT. If your plan/insurer has changed or another plan has been added, please inform the office staff. In addition to fulfilling anti-fraud requirements, disclosure of your current insurances will speed the settling of your account and minimize disruptive telephone calls seeking information.

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Insurance Matters – General:

The physicians of TriValley Primary Care participate with many commercial insurance plans, networks, and other payors, including Medicare. This website (Insurance Plans Accepted on the Our Practice Page) shows a list of insurance companies, plans and networks with which TriValley physicians participate (that is, have a contract). While we strive to keep this updated, this list can only be guaranteed as of the date shown on that list. If you aren’t sure your health plan is included, please call your TriValley office, or TriValley’s Corporate office (215-257-8601).

The amount of your co-payment and deductible, and your obligation to pay it, are features of your health plan. These are obligations you have under a contract with your insurer, either directly or through your employer or other third party. In most cases, an increased or large co-payment means a lower monthly premium. Plainly stated, the co-payment is a financial decision that TriValley and its owners/providers were not a party to. The same could be said of deductibles and co-insurances. Therefore, TriValley expects that co-payments, co-insurances, and deductibles will be paid on the day of service. And, by contract, all co-payments must be paid.

For some services or situations, your health plan or other payor needs to get information from you to complete its review to authorize payment. Please respond promptly to your insurer so that your physician can be paid promptly. Failure to respond will result in the balance being shifted to you.

TriValley will file a claim to most secondary insurances, as long as that insurer will pay TriValley directly. TriValley will file a claim to a non-participating primary insurance if TriValley participates with your secondary insurance.

TriValley’s decision to participate with an insurer’s product line is a private matter. The decision is not taken lightly and involves more than financial considerations. However, patients are free to suggest to an insurer that its provider network specialist send a group agreement for review to TriValley Primary Care, Corporate office, Attn: Practice Administrator, 519 S Fifth St., Suite 130, Perkasie, PA 18944-1042.

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Questions on Services Rendered and Payments Made/Due:

Questions regarding charges for services rendered should be directed to your provider or his/ her office. Questions regarding insurance claims status or payments received from you or insurers or other payors must be directed to the Corporate office billing department at 215-257-8601.

Questions regarding ability to pay for services before services are rendered should be directed to your provider or his/her office. Your provider will make every effort to work out an arrangement satisfactory to you and our practice. If you find out after services are rendered that you don’t have the ability to pay the balance in full or when due, please contact the Corporate office billing department at 215-257-8601. We will attempt to work out a payment arrangement with you.

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Credits:

Account credits in a patient’s name may be applied to any account balance for which the responsible party or his/her spouse may be responsible, except where limited by law, court decree or contract.

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Refunds:

Refunds are remitted automatically if a credit balance exceeds $35.00. These are mailed mid-month. We will hold lesser amounts on account, unless you specifically ask for it to be paid to you. Refunds are mailed mid-month following receipt of your request.

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Special Fees:

Because of the burden that some events or activities place on the practice, fees are assessed to offset the time and expense incurred and to discourage certain behaviors. These include fees for not paying co-payments on the day of service, missing an appointment without calling to cancel or reschedule, returned check fees, and bad debt fees. For full details and the fee amounts, please see Special Fees in the Practice Topics section of the Our Practice page.

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Delinquency and Failure to Pay:

Failure to pay within 30 days of billing results in a delinquent account and may be referred to an attorney or collection agency for collection. Delinquent accounts are assessed all costs of collection, including reasonable attorneys’ fees and expenses, collection agency commissions, and court costs. Payment in full of any delinquent balance is required prior to future appointments.

Failure to pay may result in your account being sent to a collections agency and the patient being dismissed from the practice. Please keep your account current. Please pay promptly!

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Receipts:

You will receive a receipt for a payment made in a visit. Please retain this for your tax and other records. No other receipt will be provided. The IRS may not be willing to accept another document as evidence of payment.

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