As noted elsewhere, acceptance of networks and payor plans may change. Always check with the physician's office staff to see if your plan/network is acceptable. TriValley Primary Care continues to validate the insurance and payment plans it will accept.
as of March, 2008
|
INSURANCE NETWORKS |
TVPC participates with any insurance cards with these logos, except as noted |
|---|---|
|
ChoiceCare Network |
|
| Coventry Health | See HealthAmerica |
|
Devon Health & ULLICARE |
|
|
Fidelity PMG |
Will have Fidelity Benefits Administrators logo on top left of card |
| HealthAmerica & HealthAssurance |
Includes Coventry Health, HealthAmerica HMO, HealthAssurance CCPPO, and Coordinated Care PPO; but does NOT include Advantra enrollees |
|
InterGroup |
Not all insurance cards will have the InterGroup emblem, check your list of InterGroup insurances.Beech Street is part of InterGroup |
|
Private Health Care Systems (PHCS) |
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|
Valley Preferred |
All TriValley physicians have terminated participation as of Dec 31, 2004 . Note: VP AmeriHealth may be seen in-network |
|
INSURANCE PLANS |
EXCEPTIONS/NOTES |
|---|---|
|
Aetna |
If Aetna HMO (Or equivalent plan), must be on capitation list. |
|
AmeriHealth Administrators/ Intercounty |
All Plans: |
|
Benefit Concepts, Inc. (BCI) |
Must be paired with BC/BS logo or Devon Health logo |
|
Blue Cross Blue Shield |
Front of card shows an empty suitcase or a suitcase with PPO or back of card specifies that claims are submitted locally. |
|
Blue Choice |
|
|
Personal Choice |
|
|
Capital Blue Cross |
(Not participating but…) All physicians will submit claims locally through Highmark under the Blue Card program. |
|
Cigna |
Only Dr Leska participates |
|
Highmark (Blue Shield) |
All Plans (Formerly Pennsylvania Blue Shield) |
|
Keystone Health Plan East |
Must be on capitation list. |
|
Keystone Mercy |
Must be on capitation list. |
|
Medical Assistance |
Must be "Fee for service" |
|
Medicare |
Note: Medicare uses the term “Original Medicare” |
| Medicare Advantage Plans | (formerly called Medicare + Choice Plans) TriValley accepts the following Medicare Advantage Plans:
TriValley does NOT accept the following plans:
|
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Medigap & |
All Medigap plans and any Medicare supplemental plan that pays TriValley directly (most do) are accepted. |
|
PremierBlue Shield |
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|
Railroad Medicare |
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|
TriCare |
TriValley providers are no longer enrolled as Authorized TriCare providers. You may be seen by a TriValley provider, but you are responsible for the entire charge. |
|
Veterans Administration |
We submit and balance bill the patients but do not participate |
