FAQs

Frequently Asked Questions

The practice participates with the following insurers:

  • Aetna
  • Blue Cross/Blue Shield
  • ComPsych
  • Keystone Health Plan East
  • Medicare
  • PPO
  • United HealthCare/OPTUM

Unfortunately we do not participate with Medicaid or any other assistance plan. Please note, not all of our providers are participating with all of the insurers listed above; however, our office staff assist you to determine which providers are participating with your particular insurance. Keep in mind that many insurance companies do provide reimbursement should you chose to use out-of-network services. Itemized receipts are given at the time of service for those patients to submit to their particular plan.

The best source of information about your insurance plan is the member services number found on the back of your insurance ID card. Please call your insurer to get the most accurate and up to date information about your particular plan.

Our staff will discuss the fees for service with you upon scheduling your first appointment. You are expected to pay for services rendered at the time of your visit. You will be given a copy of your “encounter” form, with diagnosis and procedure marked so that you can file a claim to your insurance company. Please note, if you are enrolled in an HMO plan, your plan may not reimburse you for services from a non-enrolled provider.

We do not participate with Medicaid or any other assistance plan like Keystone Mercy Health Plan as a primary nor secondary insurance.

A co-payment or “copay” is a set dollar amount, anywhere from approximately $5 to $50, that your managed care plan requires you to pay at the time of service.  Your copay does not change depending on the service. We ask our patients to pay their copay at the time of service.  Cash, checks, and most credit cards are accepted.  If you have a Health Spending Account (HSA) through your employer, you may use it to pay for your copay.

All of our clinicians participate with Medicare. We accept Medicare’s allowed amount (allowable charges) as the amount due for services rendered.

Medicare enrollees are responsible for an annual deductible amount for outpatient (Part B) services, plus 20% of the allowable charge. If your visit is the first care you receive in a new year, you may be asked to pay towards your deductible. After the deductible is met, you only have to pay your percentage, called co-insurance.

In 2020, the annual Medicare deductible is $198. The deductible can change annually. After you meet your deductible, you are only responsible for your co-insurance (20%). For more information, please visit medicare.gov

Currently 20% of the Medicare allowed amount. If you purchase Medigap insurance, your co-insurance is typically paid in full by your Medigap coverage. If you do not have a Medigap plan, we ask that the co-insurance be paid promptly.

Each year, Medicare determines the amount that may be charged for a service by a participating provider (physician, nurse practitioner, psychologist, physician assistant or social worker). This is called the allowed amount. For each service, we bill Medicare for payment. Medicare pays to us the allowed amount, less co-insurance or deductible. Unless you have a Medigap policy that covers your co-insurance and deductible, patients are responsible for these amounts.

Yes.

A Medigap policy is a supplemental insurance policy after your Medicare Part B. It is sold by insurance companies, usually through brokers or agents. Any Medigap policy will be accepted up to the limits provided in that policy. All Medigap plans pay for all or most of the Part B co-insurance. Whether the Medigap pays in full is dependent upon the plan. Some, but not all, Medigap plans will pay for the Medicare Part B deductible. The advantage of Medigap plans is that you can compare prices from different insurers as the benefits are standardized for the twelve Medigap plans called “A” through “L.”

To learn more about Medigap policies, visit “The Official U.S. Govermanent Site for People with Medicare”. Next, on the left-hand toolbar select Plan Choices, then Medigap (Supplemental Insurance).  Note: The Medicare site does change frequently and we apologize if the instructions are not current.

If a Medicare supplement will pay us directly for the services provided, we will accept it up to the benefit level it provides. Unless we already have a separate agreement in place with the insurer, we will not discount fees lower than the Medicare allowed amount. Most types of Medicare supplemental plans are much less expensive than Medigap policies, but they offer fewer benefits.

We do have contractual relationships with some insurers that offer Medicare Advantage plans, including Aetna, Keystone, and Personal Choice. If you are enrolled in a Medicare Advantage plan, we ask that you review this with our staff upon making your first appointment.

Before your appointment, please print and complete the New Patient Paperwork. Click to download the paperwork here.  If you are unable to print the forms, please call us to let us know and we would be happy to mail you copies. Feel free to contact the office if you have questions about the forms.

Please arrive to your first appointment at lest fifteen minutes prior to your scheduled appointment. Please bring all completed paperwork, along with your insurance ID card, a photo ID, a list of your current medications (bring the containers or pictures of the prescription bottles if it is easier), and payment for your first visit.

We ask that you please arrive 15 minutes prior to your appointment.

Thank you in advance!

It is the responsibility of the patient to pay for all co-payments, co-insurance, and deductibles. It is our policy to ask for payment at the time of your office visit.

Cash, checks, Visa, Mastercard, American Express, and Discover are all acceptable forms of payment.

If you have any additional questions regarding payment, please do not hesitate to contact us by phone.  We will make every effort to work out an arrangement satisfactory to you and to the Practice. Feel free to contact us by phone during business hours, or leave a message after hours, and our staff will return your call promptly.

Please contact our billing department at (215) 793-4546, extension 16.

A Privacy Notice is a brief description of how the Practice safeguards your Protected Health Information (PHI). We provide every patient with the Privacy Notice as a requirement of the Health Information Portability and Accountability Act of 1996 (HIPAA).

We will not disclose any of your Protected Health Information (PHI) to any doctor, facility, or family member without your written permission. If you would like us to share PHI with a family member or friend, we ask that you print and complete a Release of Information Form and bring it to your next appointment.

In order to provide you with comprehensive care, our clinicians find that it is very helpful to communicate vital pieces of information to your Primary Care Physician (PCP), Specialist(s), or outside therapist; however, as a patient it is your right to determine how much of the information can be shared and with whom. Although we include a Clinical Communication Release Form in our New Patient Paperwork, you ultimately decide whether you want our clinicians to communicate with your other provider(s). In order to provide you with the best care possible, we suggest that you discuss this with your clinician at your first visit. If you would like to update or add an additional doctor or therapist with whom our Clinical Team will communicate, please print and complete the Clinical Communication Release Form and bring it to your next appointment.

As a patient it is your right to rescind or change your Release of Information Form at any time.  If you would like to rescind your existing Release of Information Form, please contact our office today.

If you have a medical emergency, please call 911.

If you need to reach our clinical team quickly, the best way to do so is by phone. We can be reached at (215) 793-4546

If you would like to fax medical documents to our office, please send them to: (215) 793-9007 . If these documents need to be reviewed urgently, we kindly ask that you also call our office to make us aware of the urgency. Thank you in advance.