Insurance & Fees

Your health insurance is designed to help you meet the cost of your medical care. Your insurance benefits are determined by your insurance plan. Each plan is individualized and it is very important that you understand your specific plan regarding benefits and requirements. For example, many insurance plans require that you receive certain aspects of your medical care from “in-network” providers. If you choose to receive medical care outside of the network, your benefits may be reduced.

When making an appointment please inform the appointment scheduler of your insurance coverage. If your insurance requires a co-payment, you will be responsible for payment at the time of your scheduled service. After your visit, you will be billed for any co-insurance and/or deductible for which you are responsible. You are also responsible for obtaining a referral or authorization from your primary care physician (PCP) if required by your insurance plan. If your PCP is a Rockville Internal Medicine physician, your referral can be generated for you at the time of your visit. But you must request the referral for it to be processed. Visits not accompanied by a required referral will be your financial responsibility.

If you do not have health insurance or you are insured through a plan that we do not participate with, you are responsible for full payment at the time of service. You can contact your insurance company to find out what your out-of-network benefits include.

At the time of check in please have your insurance card and a photo ID. You will be asked to verify your demographics. This is important for our physicians to be in touch with you regarding test results.

At check-out, your account balances will be discussed and payment will be expected. For your convenience, we accept cash, checks, VISA, MasterCard, American Express, and Discover.

If you have questions about your account, our Business staff is available to assist you Monday – Friday from 8:00 am – 4:00 pm. Please call 301.762.5020 and choose option 4 to speak with one of our Patient Account Representatives.

Insurance & Fees

The following is the list of insurances with which we participate. This will be updated from time to time as needed:

• Aetna Better Health Maryland
• Aetna Commercial/Medicare
• Aetna – (Virtual visit physicals are a non-covered service)
• Anthem BCBS
• Apostrophe
• CareFirst Adventist Tier 1
• CareFirst BCBS
• Cigna Behavioral Health (Some plans may not cover virtual visits. Please contact your insurance to verify coverage)
• Cigna Healthcare (Virtual visit physicals are a non-covered service)
• Department of Labor – Black Lung Program
• Department of Labor – Energy Program
• Department of Labor – FECA Program
• HealthNet Federal Services (HNFS) Tricare
• Humana
• Humana Military Tricare
• Maryland Medicaid
• Maryland Physicians Care
• Medicare – MD – Novitas
• Medicare – Novitas – DC/Surr. Counties
• Medicare – Novitas – DC/Surr. Counties – Revalidation
• Medicare MDPCP
• Multiplan/PHCS
• Railroad Medicare DC
• United Healthcare
• United Healthcare Community Plan- Maryland
• WebTPA – Custom Ink

*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.

Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.

Payment Options

We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.

Card-on-File

We require new patients to keep a credit card on file and existing patients to pay their balance in full prior to being seen. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.

At check-in we will:

• scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card

After your insurance has paid their portion, we will:

• notify you via email of the balance owed
• charge the balance owed to your card on file
• email a receipt for the charge

Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).

Fees

We are happy to complete forms such as school/camp, adoptions, disability, MVA and FMLA. Due to the time and medical expertise involved, we charge a fee of *$25.00* *per form.*

• In some cases a visit with a provider may be needed to complete such forms. This is at the*discretion* of your provider.
• All form fees must be paid at the time the form is dropped off.
• Please allow us *7 business* days to complete your form and we ask that you plan accordingly.