Insurance
Insurance Plan Participation List
- Aetna/Aetna Medicare
- American Community
- Anthem BCBS/Anthem Medicare/Anthem Senior Advantage
- ASC Flora
- BCE Emergis
- Beech Street
- Bureau of Workers Compensation (BWC)
- Business Administrators and Consultants (BAC)
- CCN Network
- Central Benefits
- Champva
- ChoiceCare
- Cigna PPO – (Not HMO)
- Coffinity (PPOM)
- Coresource
- Coventry Health Care
- Creative Health Plans
- Direct Care America (DCA)
- Emerald Health
- First Health
- Fortified Provider Network
- GEHA
- Golden Rule
- Great West Healthcare
- Healthspan
- Healthstar
- Humana/Humana Choice/Humana Gold Choice/Humana Gold
- Choice Plus
- Integrated Health Plan
- Interplan Health
- Kettering Physicians Health Alliance (KPHA)
- KHN Employee Health Plan Network Preferred
- Mail Handlers
- Medical Mutual of Ohio
- Medicare
- Medigold
- Multiplan *Many indemnity plans use this network – we don’t take indemnity plans
- Mutual of Omaha/Mutually Preferred
- National Provider Network (NPN)
- Ohio Health Choice Plan (OHCP)
- Ohio Preferred Network
- Preferred Care
- Premier Health Group (MVH employee plan)
- Primary Health Services (PHS)
- Private Health Care Systems (PHCS)
- Pro America
- Secure Horizons
- Three Rivers Provider Network
- Tricare-Prime requires referral
- United Mine Workers of America (UMWA)
- Unicare
- United HealthCare/AARP/Medicare Complete/Dual Complete
- United Medical Resources (UMR)
- Universal Preferred
- Up & Up
Insurance
We participate in most insurance plans. If you do not find your insurance carrier listed, please call your insurance carrier. If you are insured by a plan in which we do not participate, payment in full is expected at each visit. Because there are so many different insurance plans it is not possible for us to know the specific details of every plan. Your insurance policy is an agreement between you and the insurance company. Take the time to read your policy. It is best to know what your insurance company will cover before services are received. If you still have questions about your coverage, call your insurance company.
Co-payments
All Copayments must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect copayments from patients can be considered fraud. We must ask for your cooperation in this matter.
Deductibles
Many insurance plans require you to pay a deductible before they will begin to pay. If you are covered by such a plan, you may be required to prepay your deductible.
Proof of Insurance
All patients must supply us with an up-to-date insurance card. If you fail to provide us with your current insurance card, payment in full for all services is required until you can supply the current insurance card.
Claims Submission
We will bill your insurance carrier and assist you in any way we reasonably can to help get your claims paid. If your insurance does not pay your claim within 90 days, you will be billed for the services. Your insurance company may ask you to supply certain information in order to process your claim. It is your responsibility to promptly comply with their request. If the insurance company cannot complete processing of your claim because you have not responded to their request for information, you will be billed for the services.
Referral Authorization
Some managed care plans require the patient to obtain a referral authorization from their primary care provider prior to receiving services from a specialist. If your plan requires a referral authorization, services will be provided only if the referral authorization is at our office at the time of your visit. You will have the option to sign a waiver accepting financial responsibility for services not covered due to the lack of the referral authorization. If referral authorization is a problem, we can reschedule the appointment.