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.

TriValley Primary Care - Participating Insurance Companies

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

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