TriValley Primary Care - Care Topics

On this page are topics that describe special TriValley care topics.

TriValley Primary Care - DEXA Bone Scan

DEXA Bone Scan Service
Offered by TriValley Primary Care

Osteoporosis and DEXA Bone Scans: What you need to know...

What is a DEXA scan?

It is a means of scanning your bones with low dose x-rays to determine their density and to measure bone loss. These measurements are used to diagnose osteoporosis and a patient’s risk of fracture. DEXA is the common acronym for dual-energy x-ray absorptiometry. (DXA is the official acronym).

A DEXA scan is a simple, painless procedure that may be performed in an office setting, using a specialized device called a DEXA machine. TriValley has a DEXA machine in our Franconia Office in Telford. The patient reclines on a table that is part of the device. The scanning takes place by a movable component. The DEXA machine is operated by a Registered Radiologic Technologist and the results are reviewed by a physician. DEXA scans at TriValley are reviewed by Kelly Rose, M.D. who has had special training for this purpose.

What is Osteoporosis?

Osteoporosis is a disease of the skeleton where bones become weak due to bone tissue loss and therefore become more susceptible to fractures or breaks. Osteoporosis, left untreated, can progress silently and painlessly until the patient experiences a fracture.

Many patients may not be diagnosed with osteoporosis until they break a bone, often resulting from a minor fall or simple action such as sneezing. Vertebral fractures can be less obvious and cause symptoms such as back pain, loss of height and stooped posture.

Who is at risk for developing Osteoporosis?

Currently, it is estimated that 10 million individuals in the United States currently suffer from osteoporosis. Eighty percent of those affected are female. Some individuals are at greater risk for developing osteoporosis. They include:

  • Post menopausal women
  • A family history of osteoporosis
  • Caucasian and Asian ethnicity
  • People with a history of fractures
  • Pre-menopausal women who do not menstruate (amenorrhea)
  • Men over age 70
  • Those with diets low in calcium or vitamin D
  • People with an inactive lifestyle
  • Those who smoke or abuse alcohol
  • People using certain medications, including steroids
  • Those with a loss of height.

What do I do if I have Osteoporosis?

The good news is that your physician can help you treat osteoporosis so that a fracture is less likely to affect your life. You can change dietary and lifestyle behaviors to help improve your bone health, including taking calcium and vitamin D and exercising. Your physician can discuss these options with you. In addition, several prescription medications are now available that can help prevent and treat osteoporosis and related fractures. Your physician can use the results of your bone density evaluation to help develop a treatment plan that best meets your needs.

Vertebral Fracture Assessment

TriValley Primary Care will also perform a Vertebral Fracture Assessment (VFA) with your DEXA exam. The VFA is a low-dose x-ray exam of your spine, performed on the DEXA machine. This exam screens for fractures of the vertebrae. VFA exams are recommended for adults who have lost more than an inch of height or who have unexplained back pain. The VFA only adds a few minutes to the DEXA exam, and is performed on all patients.

How should I prepare for my DEXA scan? And, how long does the scan take?

Patients may eat and drink normally before their scan. However, patients should not take calcium supplements for at least 24 hours prior to the exam.

Patients should arrive wearing loose, comfortable clothing, free of metal zippers, belts, or buttons. You may be asked to remove eye glasses, jewelry, and any other metal objects that may interfere with the DEXA scan.

Patients should inform the Technologist if they recently had a barium exam or have been injected with contrast for any other radiologic testing.

The actual DEXA scan only takes 10-15 minutes after the patient is positioned on the table. However, please arrive 15 minutes before the exam for check-in (very brief), and allow 30-45 minutes to get in, get positioned, have the scan and then get yourself together after the exam.

Will my insurance company cover my DEXA scan at TriValley Primary Care?

TriValley Primary Care can submit claims for DEXA scans to Medicare. Medicare will cover DEXA scans for patients at risk for osteoporosis, including post-menopausal women and certain men who may also be at risk for osteoporosis. Medicare will reimburse TriValley Primary Care at 80% of their allowable amount, subject to the patient’s annual deductible. Certain secondary insurances may cover the remaining balance. Please contact your insurance company for details regarding your specific coverage.

In addition to Medicare, TriValley can also submit claims to Private Fee For Service (PFFS) Medicare plans that we participate with. These include Blue Shield Freedom Blue PFFS, Aetna Medicare PFFS and Blue Cross/Blue Shield Select Advantage PFFS.

Due to HMO referral rules, TriValley Primary Care cannot submit claims for DEXA scans to any HMO insurance. This includes so-called Medicare HMO plans such as Keystone 65 and Aetna Medicare HMO plans.

Do I need to be a TriValley Primary Care patient to have my DEXA scan performed at TriValley Primary Care, Franconia Office?

Yes, at this time, we are only performing DEXA scans on TriValley Primary Care patients.

How do I schedule my DEXA scan with TriValley Primary Care?

Inform your TriValley Primary Care physician or nurse practitioner that you are interested in getting a DEXA scan. If found medically suitable, your TriValley provider will prepare a referral for DEXA scanning. The office staff at any TriValley office can schedule an exam for you. TriValley Primary Care performs DEXA scans on Wednesday mornings and Thursday afternoons at our Franconia Office.

Contact us at:

TriValley Primary Care, Franconia Office
211 Telford Pike
Telford, PA 18969
(215) 723-7833

Directions to TriValley Primary Care, Franconia Office

From the Intersection of Route 63 & Route 113, Harleysville:
Go North (East) on Route 113. At the fourth traffic light, make a left turn onto Cowpath Road. Turn left at the first traffic light onto Telford Pike. Turn right into Indian Valley Shopping Center, where the office is located.

From Route 309:
Exit at the Souderton Exit, Route 113.
Drive South (West) on Route 113, following Route 113 through downtown Souderton (approx 4 miles). At the fifth traffic light, make a right turn onto Cowpath Road. Turn left at the first traffic light onto Telford Pike. Turn right into Indian Valley Shopping Center, where the office is located.

For more information on bone loss, these websites are recommended: and

Information for this feature was obtained in part from the National Osteoporosis Foundation and the Radiological Society of North America.

Lower Salford Laser

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Travel Medicine

A service offered by Phyllis Shuhler, M.D. and TriValley Primary Care

1. What is travel medicine and who would be referred for a travel medicine consultation?

Travel medicine is for any person traveling to foreign countries where they may be exposed to parasites or diseases not commonly found in the United States of America. Of particular interest would be people traveling to under developed countries such as Africa, Southeast Asia, South or Central America, as well as rural Mexico.

Travel medicine includes treatment to prevent travel-associated illnesses such as deep vein thrombosis (DVT), insomnia, jet lag, mountain sickness, motion sickness, as well as advise regarding foods, beverages, bug sprays and sunscreens. Depending on where you are traveling, malaria pills or shots to prevent various illnesses such as Typhoid, Hepatitis A and Yellow Fever may be required. Depending on which part of the world you may be traveling, insect borne diseases can be of major concern and will be discussed. A plan of preventive care will be presented to you during your consultation.

2. Who would I contact for a travel consultation?

Phyllis M. Shuhler, M.D., TriValley Primary Care, Upper Perkiomen Office, performs the travel consultations. Dr. Shuhler completed Fellowship training at University of London’s School of Tropical Medicine and Hygiene. She is a member of the Royal Society of Tropical Medicine and Hygiene. She remains current in her continued medical education through this program. Dr. Shuhler worked in Ghana, West Africa, for three months in 1975 and again for a year in 1980-1981.

An appointment with Dr. Shuhler can be scheduled through our Upper Perkiomen Office by calling (215) 679-9321. She recommends that you contact the office as soon as your travel arrangements are made.

If several vaccines are required, Dr. Shuhler recommends that your visit be scheduled 2-3 months prior to your departure. It is usually a one-time office visit during which a plan of action can be set-up that could be followed by your personal private physician’s office. It is imperative that you schedule an appointment at least two weeks prior to your departure to ensure that you have adequate protection from possible illnesses, as it will take two weeks for some vaccines to become effective.

If your appointment cannot be scheduled during Dr. Shuhler’s regular office hours, special arrangements may be made to accommodate your needs.

3. What is included in a travel consultation?

Dr. Shuhler will review your past medical history and current medications to ensure that there are no interactions or risks while out of the country. She will advise you on what vaccines you need prior to your departure, as well as what medications you should take to prevent illnesses while traveling.

4. What are the costs for a travel consultation?

Dr. Shuhler does charge for her consultation, time and expertise. Unfortunately, most insurance companies do not offer coverage for this preventive care or the vaccines required for travel.

Vaccine prices are variable depending on the costs to our office. Adult Diphtheria Tetanus (DT) is strongly recommended, especially the Diphtheria part, as well as Inactivated Polio Vaccine (IPV). If your private doctor does pediatric care, they should have those vaccines available.

Other recommended vaccines, depending on your place of travel include Yellow Fever ($77)*, Hepatitis A ($74)*, and Typhoid ($55)*. Hepatitis B vaccine ($68)* is recommended for people working with sanitation or in the Healthcare field. Hepatitis B is a series of three (3) vaccinations.

The cost of Malaria medications varies. This medication is dependent on the resistance of malaria in your chosen country and any medical conditions you may have. Dr. Shuhler will provide a written prescription for the malaria medication that can be obtained at Professional Pharmacy in Pennsburg, (215) 679-9700.

If you prefer to use your own pharmacy or pharmacy plan for the malaria or any of the needed medication or vaccines, Dr. Shuhler would provide a prescription to take to your personal pharmacist. Please allow extra time for them to get the medications, as it is not a routine prescription they would typically have in stock.

* The above vaccine prices are subject to change without notice.

5. Where can I find additional information on Travel Medicine?

Additional information regarding travel medicine may be obtained from Executive Health Services, Travel Vaccine Clinic at the Philadelphia Art Museum office at 1-800-ASPIRIN.

In summary, a travel consultation is strongly recommended for anyone going into an area of development, especially in Africa, South or Central America and the Far East. If you have future travel plans overseas and feel that you would benefit from a consultation, please do not hesitate to call (215) 679-9321 to schedule an appointment with Dr. Shuhler.

Phyllis M. Shuhler, M.D.
TriValley Primary Care
Upper Perkiomen Office
101 W. 7th Street, Ste. 2C
Pennsburg, PA 18073

Phone: 215-679-9321

Patient Centered Medical Home

Patient Centered Medical Home - Recognized Practice

Patient Centered Medical Home (PCMH) is a model of care that ensures the patient’s care is coordinated, so that treatment is always rendered with regard to the whole patient.  PCMH recognition is obtained through a process of evaluating standard treatment practices by the physicians and other health care providers. Patient Centered Medical Home Recognition is awarded by the National Committee for Quality Assurance, via its Physician Practice Connections and Patient Centered Medical Home Recognition Program.

Through the dedication to patient quality care of the TriValley owners, each TriValley Primary Care office has been awarded the highest level of PCMH recognition. The date in the emblem above indicates the year in which the standards were set that TriValley offices met.

The principles of a medical home are outlined in a joint statement by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association, which was published in 2007.

These Joint Principles include:

  1. A personal physician: each patient in our practice is assigned a primary care physician, who coordinates that patient's care.
  2. Physician directed medical practice: the personal physician leads his or her team of professionals who collectively manage the patients’ care.
  3. Whole person orientation: a medical home is responsible for the whole patient, coordinating care for all stages of life. Whether the patient is being seen for acute, chronic, or end of life care, the personal physician collaborates with all caregivers so that the patient’s care is directed to the whole patient, rather than individual symptoms or diseases.
  4. Care is coordinated/integrated: a medical home follows patients through the health care system, coordinating care with hospitals, specialists, home health agencies, and nursing homes. This ensures the patient does not encounter any lapses in care, and improves patient outcomes. Patients can expect their care to be coordinated across practices, so that if the personal physician refers the patient to a specialist, they are also coordinating care with that specialist through an exchange of clinical information.
  5. Quality and safety: a medical home strives to achieve the highest quality of care with defined clinical quality outcomes backed by evidence-based medicine. Patients can expect their personal physician to monitor their progress towards these clinical quality measures and work together to achieve the best possible outcomes.
  6. Enhanced access: medical homes must be accessible to patients with same-day appointments and electronic communication capabilities, such as those our patients will find on the patient portal. Payment: medical homes will be properly reimbursed by insurance companies in recognition of the added value patients are receiving.

TriValley Primary Care physicians endorse, recognize and adhere to the principles outlined above, and underwent a rigorous recognition process to attest to their adherence.

Through participation in, and adherence to, such programs as Patient Centered Medical Home, our patients should expect to receive the highest level of quality medical care when they seek treatment with a TriValley Primary Care provider.

TriValley Primary Care

QuikMedsSM Program

QuikMedsSM is TriValley's answer to higher co-payments for drug card use and drug costs. What is  QuikMedsSM?

QuikMedsSM is a cash and carry generic drug program, that is, pre-packaged generic drugs that you can purchase and take with you from this office.  QuikMedsSM are reasonably priced – lower than most prescription plan co-payments.

  • Cash, check and credit cards are accepted.
  • No insurance plans will be billed.

If interested, please ask your TriValley provider if your medications are available via QuikMedsSM.

Controlled Substances

TriValley Primary Care in an effort to manage chronic conditions more effectively is enacting a Controlled Substances Management Agreement between doctor and patient on new and long term prescriptions classified as controlled substances. Please read it carefully. Failure to adhere to the terms of the agreement include dismissal from the practice.

Please use the Type and Tab feature described below to complete the form, but DO NOT SIGN THE FORM UNTIL YOU HAVE DISCUSSED THIS WITH YOUR PHYSICIAN.

Type and Tab: This agreement is designed to be completed on your computer using Adobe Reader.* Click on the agreement to open it, then start by clicking your mouse pointer on the first field. You may use the Tab key to move to the next field to be entered. Please review the information you entered, and print it by clicking on the Print Form button at the bottom of the agreement. Please hand the agreement to the receptionist as you arrive. Do NOT sign the agreement until your appointment.

* Note: Or, you may simply print the agreement by clicking on the Print Form button at the bottom and complete it with a pen. Please print legibly.

Controlled Substances Management Agreement

If you do not have Adobe Reader installed, click here to get the latest version.



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