TriValley Primary Care - Lower Salford Office
484 Harleysville Pike
This is the home page of the Lower Salford office of TriValley Primary Care. Welcome!
The other tabs (at the top) feature topics which describe the services we provide and certain attributes and characteristics of this office. Please click on the topic of your choice. First time visitors are encouraged to read the Welcome page. Please come back often as the content may change. Navigation Note: To return to this page, click on the Home tab.
Welcome and Commitment
Welcome to the Lower Salford Office of TriValley Primary Care! The physicians, nurse practitioners, and our staff, are committed to offering you competent, caring medical services in a setting that is comfortable and convenient. Our office is committed to serving as the advocate of our patients in all health-related matters, including appropriate use of community health resources and the appropriate referral to other specialists and to therapists and to facilities.
Our physicians are trained to care for your entire family, from newborns, children and adolescents to adults and seniors. The family practitioner oversees each aspect of the patient's care, both preventive and curative in the fields of pediatrics, adult medicine, sports medicine, gynecology, health counseling, preventive care, and geriatrics.
We are accepting new patients. If you like how you are treated, please tell your family, friends and neighbors.
Like you, we must adhere to insurance company rules, so we ask that you be prepared to pay any co-payments due at the time of service, and that you understand that there are some services that we are barred from providing to you even though we are trained to do them.
Our services are available by appointment. However, if you are sick during our regular office hours, please call the office and let the scheduler know you are sick. We will try to see you that same day. A physician is available 24 hours each day to address your urgent medical needs that cannot wait until the office re-opens.
Providers in this office have a long tenure in this community and have enjoyed long term relationships with our patients. We strive at every visit to exceed your expectations for office based primary care services. Our physicians are beholden to no one but their patients for the services they provide. Our providers are board certified in their specialty and maintain that certification through continuing medical education of not less than 50 hours per year.
Our physicians are on staff at Grand View Hospital, nursing homes and retirement communities and provide services for hospice patients in the area. As a patient advocate, we would like to know your experience or that of a loved one with these facilities. Please tell your provider or one of the staff.
If you are dissatisfied with our services or the manner in which you are treated, we want to know how we fell short of your expectations. Your compliments and suggestions are always welcome. Please tell your provider or one of the staff. There is also an electronic means (Feedback) on this website to provide your comments and suggestions to us.
We invite you to review these Office Topics to familiarize yourself with office policies and our capabilities and services. We look forward to serving you. Again, welcome to our office, and welcome to TriValley Primary Care!
Our normal office hours are:
Monday........................8 AM - 5 PM Tuesday.......................8 AM - 5 PM Wednesday.....................8 AM - 7:30 PM Thursday......................8 AM - 8 PM Friday........................8 AM - 4 PM Saturday......................8:30 AM - 12 PM
Medical office visits are by appointment. Please note that appointments may be restricted to certain hours within the schedule above. You may stop in to discuss a bill, drop off forms, etc.
The office may change hours without notice, and may close early or open later at any time (for example, due to inclement weather). If you do not have an appointment, and you do not have your own transportation, please call ahead to see if the office is/will be open.
Also, please see the Appointments tab and the How to Reach Us tab.
Office visits are by appointment so that we can better serve you. The appointment phone lines are open at 9 AM. Please call at or after this time to schedule an appointment.
Patient Portal: You may request an appointment at any time via the Patient Portal.
If calling the office, please let the scheduler know why you want the appointment (follow-up, physical exam, routine check-up, immunizations, pre-operative exam, Pap test, symptoms of______, having trouble with ___, would like the doctor to look at ____, etc.).
Same day appointments: If you are sick, please let the scheduler know. We will try to see you that same day or as soon as we can.
Please arrive on time for your appointment. New patients are requested to arrive 15 minutes prior to their scheduled time.
Please bring your insurance card with you, and funds for your co-payment/co-insurance. Also, please bring any forms that you need completed with you. And, bring your medication bottles for drugs and over the counter medications you are currently taking. Please remember to state your prescription status ("I need a refill") during that visit.
In addition to the above, new patients are asked to bring photo identification (passport or driver's license) and social security number. New patients should bring your medication bottles for drugs and over the counter medications they are taking; and be prepared to give their medical history (current and past illnesses, dates of surgeries, etc.) See the Guide for New Patients (via the Link to Practice Topics)
Two days in advance of the appointment, you will receive an automated (computer generated) telephone call reminding you of the appointment. This is a courtesy call.
Cancellations and Rescheduling: If you cannot keep an appointment, please notify us as soon as possible. Phone: (215) 256-8040. Please note that there is a charge for failure to cancel an appointment in advance.
Also, please see the How to Reach Us tab
As your family doctors, we are able to care for most of your medical problems and those of your entire family.
Our services include:
Please ask a provider if there is a service that you don't see here.
In addition to the above services, TriValley Primary Care providers offer travel medicine, Acupuncture and DXA Bone Scan services for Medicare patients. And, the QuikMedsSM (cash and carry medications) service is also available in many TriValley offices. Finally, Laser Hair Removal is offered at this office.
How to Reach Us
Our mailing address is the same as our street address, given on the office Home tab.
Telephone access is by our main number: 215-256-8040 You may key this 24 hours per day, each day.
During office hours, the telephone calls are answered by an "automated attendant" that will direct your call to the appropriate party. For your convenience, the following is the key to the automated attendant:
If you do not have a touch tone line, you may stay on the line and someone will pickup.
You may telephone our office whenever you have a question about your health, your care, your medication or other health related subjects. Often, one of our nurses can answer all of your questions. You may be asked to come in, so that your condition can be treated effectively.
When the office is closed, closing, or just prior to opening, and at certain other times, the "automated attendant" message will be different than that shown above.. If you have an urgent medical condition, there is the ability to speak with the answering service who will take your information and contact the physician on duty as appropriate and provide instructions as to what to do. See also After Hours and Urgent Care
As to other methods of reaching us, you may request a referral or a prescription refill or an appointment, as well as leave routine NON-URGENT messages for the office staff via the Patient Portal. These requests and messages are handled by TriValley staff that have access to your medical information. There are several advantages to using the Patient Portal including speed and accuracy of providing the information, and the improved routing and response time. Plus your information is stored with your other medical data.
The office can accept facsimile (fax) transmission, but these are usually accepted at the suggestion of the office staff.
Inclement Weather: If the area experiences severe weather (primarily, snow and ice accumulation on roads), the office may open later, or may close for the day. Please call the main telephone number, given above, to check if the scheduled office hours have been affected due to weather.
Also, please see the After Hours and Urgent Care tab and the Appointments tab.
After Hours and Urgent Care
A physician is on call 24 hours each day to address urgent medical needs that cannot wait until regular office hours.
If the office is closed, the answering service will take your information and contact the physician on duty who will return your call and provide instructions as to what to do, as appropriate.
The Automated Telephone Attendant remains active while the office is closed. This allows patients to leave messages in specified mailboxes, which will be addressed when the office re-opens. For your convenience, the menu for the automated telephone attendant is below:
If you have a pressing medical condition during scheduled hours, our office is equipped to handle minor injuries, lacerations, asthma attacks and other urgent problems. Please call the office and describe what your condition or symptoms are. If your condition is urgent, then you'll be seen or referred for proper care.
However, if a medical emergency should arise, please go quickly to the nearest hospital emergency department or call 911 immediately.
For certain medications, and for certain situations, such as if the patient has not been seen by a TriValley provider within a year, you may be asked to make an appointment to be seen before that medication is refilled. In general you must be seen in the office if your prescription is more than a year old.
There are three ways to renew a prescription.
If you use the first or second method, please refer to the medication bottle for needed information.
Our office will call you only if there is a need for you to pick up the script (rarely, except for a narcotic), or to request that you make an appointment before the refill will be considered, or if the information submitted is incomplete or there is a question or issue regarding it.
Local pharmacy: Please call the pharmacy to make sure the drugs are ready for pick-up.
Please allow 48 hours for the prescription renewal request to be processed. Renewals are not processed on weekends or holidays. In most cases the renewal will be sent electronically to the pharmacy or pharmacy benefits manager. Note: With today's technology linking providers, pharmacies and data depositories, picking up a written script is rarely needed, except for a narcotic.
Tip: Please bring all of your medication bottles - both prescription and over the counter - with you to every appointment. Also, please remember to mention any prescriptions needed at the time of your office visit. We can take care of them very easily at that time.
* Making your request for your prescription renewals online via the Patient Portal has the advantage that you can see the current medications you are taking and therefore reorder the correct item and dosage, etc.
Referrals for Care
Some managed care plans require referrals to be issued before visiting another specialist physician, therapist, or for certain services at a facility (for example, hospital or imaging center). Your problem or condition should be evaluated first by your primary care doctor. Once referred, the specialist doctor may want to see you back for a follow-up visit.
There are two ways to request a referral. You may either,
Referral policies are detailed in a separate brochure available in the office or by reviewing the Managed Care topic in the Practice Topics selection on the Our Practice page.
To make a referral request, certain information is needed. The needed information via the Patient Portal is as follows:
Please allow 48 hours for the referral request to be processed. Referrals are not processed on weekends or holidays. In most cases the referral will be sent electronically to the specialist or facility. But certain insurance plans require that you pick up the completed form from our office.
The doctors in this office are affiliated with the following hospitals in the region.
Grand View Hospital
Note: Web links (URLs) to the facilities are available on the Our Community page (via the MAIN button, above).
While not actively managing hospitalized patients, your TriValley doctor will be involved in the coordination of care and will work with other specialists on the hospital staff to assist with diagnosis and treatment and follow-up care.
If you are admitted to the hospital as an emergency, we ask that you notify our office as soon as possible, so we can coordinate your follow up care. It is helpful if you or a family member give the name of your TriValley doctor to the hospital staff during the admission process. This will enable us to receive prompt notice of your admission and your discharge and discharge instructions.
When you are discharged, we will get a report summarizing the care you received, and what medications you have been prescribed. In most cases, we will provide the majority of your follow up care.
Also, please see the Newborn Care tab
Nursing Home and Continuing Care Retirement Communities
Providers/Physicians in this office provide medical care for patients in certain Nursing Homes, Skilled Nursing Facilities, Assisted Living and Continuing Care Retirement Communities in this area. If you are being transferred to one of these facilities, you may request from the administration of the facility that a TriValley physician provide your care. Among these facilities are:
Note: Web links (URLs) to the facilities are available on the Our Community page (via the MAIN button, above).
We visit patients at these facilities and direct their medical care by communicating with the administrators, therapists and nurses who provide the care.
In a Skilled Nursing Facility, whether for long term care or short term rehabilitation, physicians will see patients shortly after admission, once every 1-2 months for routine check-ups, and as needed.
Patients in Assisted or Independent Living make appointments with us at our office or, in some cases, at their location.
Special Note to Family Members: If you have Power of Attorney over the medical affairs of a loved one, please let this office know so that statements and other communications can be sent appropriately. Health Insurance Portability and Accountability Act of 1996 (HIPAA) applies to patients in nursing home settings. Please see the Patient Forms page in the Practice Topics section (via Link to Practice Topics) to view the Notice of Privacy Practices and complete the Acknowledgment of Receipt of Notice form and the Authorization for the Use and Disclosure of Individually Identifiable Health Information form. Finally, if there are changes in health insurance, please let this office know.
TriValley has two Nurse Practitioners specializing in care of geriatric patients, who assist us on a daily basis at some of these Nursing Homes.
Below is descriptive information about the various facility types.
With regard to nursing homes and skilled nursing facilities, your TriValley physician works as part of the nursing home team. Your medical care will be furnished by your physician, but much of the supportive and other care will be provided by either nursing home staff or via services arranged by the nursing home. Unlike a hospital where a physician visit may be once or twice daily, your physician will see the patient based on a care plan that is tailored to the patient's needs and usually calls for visits no more than every other week, or once a month.
A TriValley Certified Registered Nurse Practitioner may see the patient on a routine basis in collaboration with your physician. A TriValley nurse practitioner is a master's prepared (Master of Nursing), registered nurse licensed by the Commonwealth of Pennsylvania to deliver much of the same care as your physician. A nurse practitioner may see the patient first after admission to do an assessment and take care of any immediate medical needs. Your physician will then see you, and prepare a plan of care.
Many Assisted Living and Continuing Care Retirement Communities have onsite exam rooms that you can see your physician there rather than coming to the physician's office.
Physicians in this office coordinate patient care with hospice agencies.
"Hospice care is provided to patients who have a limited life expectancy. Although most hospice patients are cancer patients, hospices accept anyone regardless of age or type of illness. These patients have also made a decision to spend their last months at home or in a homelike setting."*
In most cases, patients select hospice care as part of discharge planning in other facilities. However, please feel free to discuss the issue with your TriValley physician as the need arises.
"The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends."
"To find the best hospice for your needs, ask your doctor, healthcare professionals, clergy, social workers or friends who have received care for a family member. You may want to call or meet with the hospices and ask questions about their services."
Even if the patient's TriValley physician isn't actively caring for the hospice patient, the hospice will normally contact TriValley to see if the physician agrees that patient is a suitable candidate for hospice.
Family practitioners are trained to provide health care and treatment for newborn children.
In-office care is provided the baby at 2 weeks and 4 weeks; and at regular intervals per the physicians instructions thereafter; then, annually beginning at age 2.
TriValley has prepared a booklet that provides advice on newborn care entitled, "Handbook for Parents: The Second Nine Months"*. If it isn't provided to you when your baby is in the nursery, please ask the office to provide it to you on your next office visit with your infant.
*Fun fact: This booklet predates the founding of TriValley Primary Care. It was developed by physicians of Indian Valley Family Practice in Hilltown Township, which became the Indian Valley office of TriValley Primary Care in 1995. Lori Rousche, MD was the principal author. It has been updated over the years as new information has become available.
Women's Health Services
Physicians and nurse practitioners in this office are trained to perform physical examinations, including breast exams and Pap tests on women. These may be scheduled through the normal appointment process (see the Appointments tab)
In addition, TriValley's DXA Bone scan service is an important diagnostic service for some women. TriValley Primary Care can submit claims for DXA scans for Medicare patients. Medicare will cover DXA scans for patients at risk for osteoporosis, including post-menopausal women (and certain men) who may also be at risk for osteoporosis every two years. Please click on the link above to learn more.
The transfer of patient medical records falls under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules. As such, the process must be done correctly and by the correct party.
When a patient requests the transfer of medical records, the request must be in writing and include the practice name, name of doctor, address and phone number where the records are currently maintained (if transferring records into this office) or where they are to be transferred to when transferring records from this office.
Transfer Records To TriValley:
To transfer your records into TriValley Primary Care, you can do one of two things:
Transfer Records From TriValley:
If you would like to transfer your records out from TriValley Primary Care to another physician, please use our Authorization for Release of Medical Records (Records Out). Click here to download a copy of that form. Please complete both sides of the form in full. Once the form is complete, you may drop it off at our office or mail it to our office (address at the top of this page).
You'll be asked why you are transferring. Please tell us why you are making the change. Thank you.
Our Community (Lower Salford)
The Lower Salford office is located in Lower Salford Township, Montgomery County and in the Souderton Area School District. This feature describes some of the activities the physicians and staff of this office are involved in to make it a better community. A section, below, explains this office's role in training of medical students/residents and other healthcare students. In addition, there is a section showing the hospitals and nursing homes and assisted living/retirement communities with which our providers frequently interact.
Lower Salford Gives Back
The physicians and staff have had an extended involvement with the people, businesses, and services of this community. We benefit from, and greatly appreciate, the governmental, commercial, educational, artistic, cultural and other societal services and resources in this area and region. We are happy to live and work here, and to educate and raise our children here. The following are some of the ways in which our physicians and staff have contributed their time, talents and money for the betterment of people and activities in this community and beyond.
The office participates in or contributes to these TriValley-wide charitable activities:
TriValley PowerWalk/PowerRun which was a fund-raising event held to benefit the Indian Valley Boys & Girls Club in Souderton.
Lee National Denim Day is held each fall in which staff members contributing $5 each may wear jeans (denim) to work for the day. The physicians of TriValley Primary Care match the employee donations. The funds raised benefit breast cancer research.
Pennridge FISH Organization, Inc., a local charitable entity that provides a food bank, benefits from a canned food drive held by TriValley each fall.
The office and its staff also supports, or has lent its support to, the following:
Manna on Main Street, a soup kitchen for the underprivileged and homeless in Lansdale, receives all proceeds from the sale of cookbooks created by the staff of the Lower Salford Office.
Training & Precepting Students
Another form of giving back is to assist in the training of future healthcare professionals. The current complement of providers in our office are providing (or have provided) their services without remuneration to train students from the following institutions:
Thomas Jefferson University Medical School (medical students) by Dr. Pierotti
Note: Links to the following are available on the Our Community page (via the MAIN button, above).
Physicians in this office have clinical privileges with the hospitals shown in the Hospitals tab
Nursing Homes/Retirement/Assisted Living Communities
Health care providers in this office have clinical privileges with the Nursing Homes, Retirement, and Assisted Living Communities shown in the Nursing Home and Continuing Care tab
Other Healthcare Entities
Physicians in this office have clinical privileges with several hospices. They also have direct involvement with home health and visiting nurse organizations.
Moreover, Richard Pierotti, MD is a medical director with Indian Creek Foundation.
Chambers of Commerce
TriValley Primary Care is a corporate member of these chambers of commerce:
Indian Valley Chamber of Commerce
Lower Salford Office History
This is a brief overview of the office, both as a facility and regarding its provider staff. Those of you who have been in the area for some time may recognize some familiar names from the past. Note: details regarding current TriValley providers are provided on their web pages.
R. Lawrence Derstine, M.D. began a new practice in Harleysville in 1967 following two years service with the US Air Force in Syracuse, New York. His practice was located at Main Street and Maple Avenue.
In January 1977, the practice moved into a new building at 484 Harleysville Pike, Lower Salford Township, Harleysville.
In 1979, Richard Pierotti, MD joined Dr. Derstine at the completion of his residency program.
In 1980, the practice was named Lower Salford Medical Associates.
Joseph Ulasewicz, MD joined the practice in 1988 upon completing his residency program.
In 1991, Susan Underwood, MD joined them upon completing her residency program.
Also in 1991, the building was expanded to include a new wing, adding additional exam rooms and related space.
In June 1995, Drs. Derstine, Pierotti, Ulasewicz, and Underwood joined several other local physicians in forming TriValley Primary Care. The doctors continued working from their Harleysville office, which became the Lower Salford office of TriValley Primary Care.
In 1996, the front office and reception area were reconfigured to better serve the patient volume.
Karen Pavlick, MSN, CRNP joined the office in June 1997 having completed her nurse practitioner masters degree program.
In 1999, Curt Carlier, MD joined the office upon completing his residency program.
In September 2004, David Buckwalter, MD, a medical school classmate of Dr. Carliers, joined the office from a practice in Lebanon County.
Dr. Derstine retired in December 2004.
In the spring of 2006, Eileen Zitzer, MSN, CRNP joined TriValley from a practice in Jenkintown.
Eileen Zitzer, C.R.N.P. relocated to New Jersey in June 2012.
Dr. Buckwalter relocated to Maryland at the end on 2012
Deborah A. Topakas, DO joined TriValley in July 2013 from a local hospital owned practice in Plymouth Meeting.
Dr. Pierotti retired at the end of August 2013.
Reps and Vendors
The terms and policies detailed in the Vendor Guide that is provided in the Practice Topics section (via Link to Practice Topics tab) applies to this office.
In this office, detail visits by Pharma reps are coordinated by the Office Supervisor. If you want to schedule a presentation with an in-office meeting, please ask to speak with the front desk to schedule a meeting date.
Delivery or inventorying of drug samples may be done during regular office hours without an appointment. Access to the sample storage area (room) is not permitted.
Other Reps and Vendors
You are reminded that no solicitation calls will be accepted, and that the Postal Service is an excellent means to provide an introductory letter.
Link to Practice Topics
The link to the Practice Topics is provided as a convenience. Practice Topics include features and policies that are common among the offices of the TriValley Primary Care medical group practice.
Practice Topics (on the Our Practice page) may be reached via this link (click here).
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