Insurance & Payment

Patient insurance requiring a PCP selection must contact their insurance to change the practice selection to a specific provider selection using the TIN and Group NPI

Tax ID # 54-0967672   Group NPI # 1083793525

Open to New Patients:

• Aetna (HMO and PPO)
• Aetna Innovation
• Aetna Signature Partners
• Anthem (HMO and PPO)
• Blue Cross Blue Shield (HMO and PPO)
• Care First (HMO and PPO)
• Champ VA (Courtesy File)
• Cigna (HMO and PPO)
• Cigna Connect
• First Health/PHCS
• Johns Hopkins (US Family Health and EPHC)
• MediNcrease
• Multiplan
• Optima-Sentara (not Medicaid)
• Partners Direct Health
• Prime Health Services
• Student Resources (Aetna and UHC)
• Tricare Select/Standard
• United Healthcare (HMO and PPO)
• Surest
• Virginia Health Network
• Web TPA

NOT Open to New Patients:

• Cardinal Care- Anthem HealthKeepers Plus (Medicaid MCO)
• Cardinal Care- United Healthcare Community Care (Medicaid MCO)
• Cardinal Care- Optima Health Community Care (Medicaid MCO)

NOT Contracted: 

• Kaiser (HMO)
• Aetna Better Health of VA (Medicaid MCO)
• Molina Complete Care formerly (Medicaid MCO)

                                                                                                                                                           Revised 10/10/2023

Well Check Appointment

Copayment or No Copayment?

Even if a physical or preventative test is fully paid by insurance, you may STILL have a copayment/coinsurance/deductible for the visit.
See explanation below:

Your child’s Well Check (Physical), which includes a routine physical examination, routine labs, routine vision or hearing and routine immunizations normally does NOT require a copayment.

HOWEVER, if you discuss concerns or symptoms of acute or chronic conditions or a problem-oriented condition is discovered during the well check, it is considered “diagnostic” and you will most likely be required to pay a copayment/coinsurance/deductible if applicable.

Example:
An appointment is scheduled for a Well Check (Physical).
During the physical, you express concern(s) and are treated for an un-related problem: symptoms of acute illness (cold, cough, ear pain, rash etc), concerns about an uncontrolled chronic condition (ADHD, skin problems, weight issues, etc) or requesting changes to medications.

In compliance with insurance company billing policies this prompts charges for both categories which require a copay or coinsurance/deductible, should you have one.