Insurance

UPDATE 1/1/13: We are no longer accepting new patients who live outside of Virginia (with the exception of Zenker's and Spasmodic Dysphonia).

We participate with the following Virginia health insurance companies (subject to change). We are happy to see all patients irrespective of insurance. However, if we see you for a visit and we do not participate with your health insurance, we will bill YOU directly all charges. We will be happy to provide a receipt which you can submit to your insurance company for reimbursement. Alternatively, you can request a "Letter of Medical Necessity" from you primary care doctor for temporary non-par provider health insurance coverage.

Please note that many health insurance policies do have out-of-network benefits but your out-of-pocket costs will be higher than if you see an in-network physician. This is particularly true if you live OUTSIDE OF VIRGINIA, even if your health insurance plan is listed below!

It is YOUR responsibility to determine whether our practice participates as an in-network provider with your health insurance plan or not. Click here for more information regarding what in-network vs out-of-network participation means.

For those without insurance coverage or to help pay for uncovered procedures/services, we do participate with CareCredit for flexible payment options if total charges exceed $1000 (cost can be as low as ~$50 per month over 24 months).

• Aetna
  • HMO Based Plans (HMO, QPOS, US Access, Open Access HMO, Aetna Health Fund, Choice POS, Medicare)
  • Non-HMO Based Plans (Managed Choice, Elect Choice, Open Choice, National Advantage)
• Anthem BlueCross BlueShield
  • Professional Provider Network
  • Preferred Professional Provider Network
  • PPO
  • Healthkeepers, Inc and Affiliated HMO Networks
  • Healthkeepers Plus
• CareFirst BlueCross BlueShield
• Cigna Healthcare
• First Health
• Great West Healthcare
• Humana Medicare Advantage Plans
• Mid-Atlantic Medical Services, LLC (MAMSI)
• MDIPA
• Medicaid (Only accepting new pediatric <12 years old patients)
• Medicare
• National Capital Preferred Provider Organization (NCPPO)
• Optima Health
  • PPO Only (We do not participate with any other Optima plans other than PPO)
• Optimum Choice
• Private Healthcare Systems (PHCS)
• Southern Health
• Tricare
  • Standard
  • We do NOT participate with Tricare Prime unless you are referred from a pediatrician specifically for surgery.
• Trigon BlueCross BlueShield
• United Healthcare

For all other plans in which we do not participate, the patient will be required to self-pay in full and submit to the insurance reimbursement for all office visits, testing, and procedures. YOU will be responsible for any unpaid balance, copayments, and deductibles. Please remember that YOU have the contract with the insurance carrier (NOT us for health plans we do not participate in), and therefore you assume responsibility for understanding the requirements of your specific plan. Alternatively, you can request a "Letter of Medical Necessity" from you primary care doctor for temporary non-par provider health insurance coverage.

We re-evaluate participation in various insurance plans from time to time. If your plan is not listed or you have questions concerning the above information, please contact our office at (540) 347-0505 and ask to speak with Carrie.

If you don't understand how copays, deductibles, coinsurance, premiums, etc work, click here for an explanation.