We are accepting new patients from the northern half of Virginia only (Fauquier and bordering counties only). New patients are defined as not having been seen in our office within the past 36 months. You can appeal this limitation by sending us an email. Appeals by phone will NOT be accepted. In only very rare and selective cases have we made exceptions. Read why we instituted this policy.
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 your 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.
We do participate with CareCredit for flexible payment options for hearing aids only (cost can be as low as ~$50 per month over 24 months).
We currently accept the following insurance plans:
- Aetna (All plans EXCEPT Better Health of VA, QHP plans, and healthcare marketplace exchange plans which contain gold, silver, bronze on the card)
- Anthem (All plans EXCEPT "Healthkeepers PLUS" plans for which only patients under 12 years old who reside in Fauquier County will be accepted)
- Blue Cross/Blue Shield
- Cigna (All plans EXCEPT those through the healthcare marketplace)
- Straight Medicaid (or CardinalCare as of 1/1/23 for VA Medicaid) only for those under 12 years old and reside in Fauquier County
- Medicare Replacement Plans
- Railroad Medicare
- Tricare (We are an authorized provider but NOT an in-network provider. As such, the cost share is 25% of the allowed amount.)
- We do NOT participate with Tricare Prime unless you are referred from a pediatrician specifically for surgery and reside in Fauquier County.
- United Healthcare (All plans EXCEPT "Community Health" plans)
- Includes Mamsi/MDIPA/OC, UHIS, InforMed, and Compass Rose Health Plan, and UMR
We do NOT accept these common insurance plans at this time:
- Anthem Healthkeepers Plus (if older than 12 years old or lives outside of Fauquier County)
- Aetna Better Health of Virginia
- Magellan Complete Care
- Medicaid (if older than 12 years old or lives outside of Fauquier County)
- Molina Healthcare
- Optima Health
- United Healthcare Community Plan
- Virginia Premier
CorVel worker's compensation is accepted in our office. In order to be seen by us for worker's compensation, you MUST have a claim case number provided by your worker's compensation administrator. Without this case number at time of visit, your office visit will NOT be submitted as a worker's compensation claim. Rather, your claim will instead be submitted to your normal health insurance.
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.
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.