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 |