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We are dedicated to providing you with the highest quality, cost effective medical care. We are a "cash friendly" practice, with extremely reasonable fees for patients who do not have or do not wish to use insurance. We accept all major credit cards ($15.00 minimum, please) and we offer installment payments.

INSURANCE & PAYMENTS

*Important information about Referrals

Certain HMOs require referrals before you have procedures or see specialists. Referrals are done on a website called Navinet, which sometimes has issues. Rest assured we will do everything we can to get your referrals done in time. 

 

Information we need for your referral: 

 

  • Your ID number and date of birth

  • Your ICD-10 diagnosis (ask the specialist)

  • The specialist or facility's 10-digit NPI number

 

Special Rules for Aetna HMO:

  • All radiology procedures must be done at Community Radiology (Phoenixville Hospital or Limerick)

  • Physical Therapy must go to NovaCare

  • Labs must go to Quest Diagnostics (if we don't draw your blood in the office)

  • Podiatry must go to Dr. Michael Drohosky in Phoenixville

 

Special Rules for Keystone Health Plan East: 

  • All radiology procedures must be done at Community Radiology (Phoenixville Hospital or Limerick)

  • Physical Therapy must go to NovaCare

  • Labs must go to LabCorp (if we don't draw your blood in the office)

Insurance: 

 

We accept nearly all major insurance plans including:

 

  • All Aetna plans

    • PPO, POS

    • HMO

    • Independence Blue Cross

      • Personal Choice

      • Keystone Health Plan East HMO*

  • Medicare

  • Most Medicare Advantage Plans

  • Cigna

  • TriCare

  • United HealthCare (as of 6/16/16)

 

 
Pre-Certifications/Prior Authorizations

 

Some procedures, typically MRI and some CT scans, require Pre-Certification (sometimes also called Prior Authorization) by insurance companies. This is different from a referral. It requires us to submit information about you and the reason you need the study, and is done by the ordering physician. If your orthopedist wants an MRI of your knee, they must do the Pre-Cert, not us. When a Pre-Cert is required, it takes the place of the referral; that is, you do not need a referral in addition to the Pre-Cert.

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