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 | Independence Blue Cross (Keystone 65 and Personal Choice 65) Aetna Medicare plans Keystone Focus UnitedHealthcare Medicare Advantage Humana Medicare Advantage Devoted Health DO NOT ACCEPT: |
|
| Medigap & Medicare Supplemental Policies | All Medigap plans and any Medicare supplemental plans that pay TVPC directly (most do) are accepted. | |
| Partners Direct Health | Effective 1/1/2023 | |
| 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 |
