Insurance Plans and Networks Accepted by TriValley

As noted elsewhere, acceptance of networks and insurance plans may change. TriValley Primary Care continues to validate the insurance and payment plans it will accept. Always check with with your insurance plan that your TriValley provider is an enrolled provider. Note: Medicare beneficiaries are assured that all TriValley providers are participating providers with "original" Medicare.

ACCEPTED INSURANCE PLANS and NETWORKS

TRIVALLEY PARTICIPATES WITH

as of March 2015

INSURANCE NETWORKS

TVPC participates with any insurance cards with these logos, except as noted

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

Aetna

If Aetna HMO (or equivalent plan), must be on capitation list.

HMO patients selecting a TriValley office, please provide one of the following numbers to the Customer Service Rep. (on back of card):

Lower Salford      40050
Pennridge          40049
Upper Perkiomen    101
Franconia          40057
Lansdale           40030
Western Bucks      1289
Indian Valley      40055

AmeriHealth Administrators/

All Plans:
Note: Valley Preferred AmeriHealth may be seen in-network

Benefit Concepts, Inc.  (BCI)

Must be paired with BC/BS logo

Blue Cross Blue Shield
or
Blue Shield

Front of card shows an empty suitcase or a suitcase with PPO or back of card specifies that claims are submitted locally.

Personal Choice

 

Capital Blue Cross

(Not participating but…) All physicians will submit claims locally through Highmark under the Blue Card program.

Cigna

Note: Includes Great-West Healthcare
All plans EXCEPT Cigna-HealthSpring (any Cigna Medicare)

Coventry &
HealthAmerica &
HealthAssurance

Includes Coventry Health, HealthAmerica HMO, HealthAssurance PPO, and Coventry Consumer Choice Excludes Advantra Silver (or any HealthAmerica Medicare plan) and CoventryCares

Highmark

All Plans

Independence Administrators

 

Intercounty

 

Keystone Health Plan East

Must be on capitation list.

If selecting a TriValley office, please provide one of the following numbers to the Customer Service Rep. (on back of card):

Lower Salford      0751623004
Pennridge          0751623005
Upper Perkiomen    0751623008
Franconia          0751623003
Lansdale           0751623024
Western Bucks      0751623006
Indian Valley      0751623001

Keystone First (formerly Keystone Mercy)

Must be on capitation list.

If selecting a TriValley office, please provide one of the following numbers to the Customer Service Rep. (on back of card):

Lower Salford      1025928
Pennridge          1025859
Upper Perkiomen    1101199
Franconia          1025948
Lansdale           1155147
Western Bucks      1025874
Indian Valley      1025773

Medical Assistance

Must be "Fee for service"

Medicare

Note: Medicare uses the term “Original Medicare”
Must have Part B coverage

Medicare Advantage Plans (formerly called Medicare + Choice Plans)
TriValley accepts the following Medicare Advantage Plans:
  • Keystone 65
  • Personal Choice 65
  • Blue Shield Freedom Blue PFFS
  • BS Select Advantage PFFS
  • Aetna Medicare

TriValley does NOT accept the following plans:

  • Advantra, Cigna-HealthSpring
  • Erickson, Evercare, Geisinger Gold
  • HumanaChoice & Humana Gold
  • Any other Medicare Advantage plans not listed above

Medigap &
Medicare
Supplemental
Policies

All Medigap plans and any Medicare supplemental plan that pays TriValley directly (most do) are accepted.

Premier Blue

 

Railroad Medicare

 

TRICARE

TriValley providers are TRICARE-certified (authorized) Non-Network Providers. All TriValley providers will accept assignment from TRICARE.

UnitedHealthcare

All commercial plans Effective Dec 1, 2012
Excludes:

  • SecureHorizons Medicare
  • Evercare
  • Community Plan Medicare
  • Pennsylvania Benefit Medicaid
  • TRICARE Benefit & other govt. plans
  • Compass Plans
  • Certain Oxford Plans (call for details)

Veterans Administration

We submit and balance bill the patients but do not participate

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