We are providers for most major insurance carriers including:
- Aetna PPO
- Aetna HMO
- Aetna Medicare & Advantage
- Amerihealth
- Auto Carriers
- Cigna
- First Health Network
- HealthPartners
- Highmark Blue Shield
- Horizon Blue Shield (non HMO)
- Humana
- Keystone Health Plan East
- Keystone Health Plan East 65
- Medicare
- Medicare – Railroad
- MultiPlan
- Personal Choice
- Personal Choice 65
- TriCare
- Workers Compensation
All Health insurances are verified prior to your visit. Please review your insurance criteria as listed below.
AETNA :
Referrals and co-pays normally required based on specific plan. Pre-Certification may be required for diagnostic, ancillary and surgical services.
Amerihealth :
IBC product. Referrals, Co-pays and Deductibles are patient responsibility. Pre-Certification may be required for diagnostic, ancillary and surgical services.
Blue Shield :
Traditional coverage. Office Visits may not be covered depending on the individual plan. Co-pays and Pre-Certification may be required for specific services based on the individual plan.
Cigna :
Co-pays & deductibles normally required based on specific plan. Pre-Certification may be required for diagnostic, ancillary and surgical services. Physical Therapy is not a covered service.
First Health :
Co-pays & Deductibles required based on specific plan. Pre-Certification may be required for diagnostic, ancillary and surgical services.
Keystone Health Plan East :
IBC product requires referrals and Co-pays unless a Point of Service. Normally no Deductibles. Pre-Certification required for diagnostic, ancillary and surgical services. Physical Therapy and MRI are capitated services. Hand Therapy requires referrals and/or Pre-Certification.
Medicare :
Government sponsored Health insurance (Part B). Yearly Deductible and Cap on Physical/Occupational Therapy services. Patient responsible for 20% supplement payment; which may be covered by AARP, Blue Shield 65 Special, etc. Please remember that Keystone 65, Personal Choice 65, Aetna Golden Rule, Bravo, etc. are Medicare REPLACEMENTS not supplements and you may be responsible for additional co-pays, deductibles, etc.
TriCare :
Military & Veteran coverage. Authorization required for treatment of Active Duty Military. Pre-Certification may be required for diagnostic, ancillary and surgical services.
Personal Choice :
IBC product No referrals Co-pays and Deductibles are patient responsibility. Pre-Certification may be required for diagnostic, ancillary and surgical services.
Workers Compensation :
Patients are required to bring a Letter generated by their W/C insurance, which will include the Date of Injury, Type of Injury (Diagnosis) Claim Number, Name of Adjustor and Address where the bills can be sent.
Auto Accident :
Pennsylvania has a No-Fault Law which covers any injury in or around an Auto. Most policies have an individual maximum of $5,000.00. The Date of Injury, Type of Injury (Diagnosis), Claim Number, Name of Adjustor and Address are required. Once exhausted all non-paid bills will be sent to your personal health insurance. If referrals are required, it is the patient’s responsibility to request Back-Up referrals at the initial time of service.
Commercial Insurances :
You are responsible to adhere to the requirements of your insurance. Knowledge of eligibility, referrals, Co-pays, Deductibles and specific allowable services is the patient’s responsibility. Check with your insurance prior to your visit.
We will assist in the Insurance process. Pre-Certifications for Diagnostic and Surgical services will be obtained by our Office, regardless of where the service is performed. Obtaining Referrals is always the Patient’s responsibility.
