Does Potomac Health & Wellness (PHW) participate with any health insurance plans?
PHW currently participates with most Blue Cross Blue Shield (BCBS) Preferred Provider Organization (PPO) health plans, including Anthem (VA), CareFirst, and FEP. PHW is also a Humana TRICARE East certified non-network, non-participating provider. PHW currently does not participate with most other health plan carriers, including Aetna, Assurant, Cigna, GEHS, Humana, Medicare (opt out), Medicaid (opt out), or United Healthcare. PHW also does not participate with most health maintenance organization (HMO), point of service (POS), or exclusive provider organization (EPO) health plans. Please contact us, before scheduling your initial appointment, to verify your health plan eligibility and to determine your office visit or e-visit fees.
NOTE: Because there has not been an established telemedicine (telehealth) standard for healthcare insurers and plans, some healthcare insurers cover patient e-visit appointments while others do not. For healthcare plans that do not cover e-visits, prior approval is required before patient e-visits will be covered. For our participating health plans' patients, PHW will submit a patient e-visit appointment claim to the specific participating health plan insurer for payment. For our non-participating health plans' patients, as well as uninsured and self-pay patients, each office visit or e-visit appointment will require self-payment at the time of the appointment. Office consultation fees are not inclusive of any optional health care or administrative services fees (e.g. third party medical records fees, patient forms, disability determinations, dietary counseling, special reports, etc.), and are solely the patient's financial responsibility since they are not covered by any healthcare plans. All patients are also solely financially responsible for all of their third party, health coordination services, including labs, pharmacies, imaging, etc., which may or may not be covered by their specific healthcare insurance plan(s). Patient office visit claims documentation, is provided upon request, for patients to submit to their health care plan(s) for reimbursement. Payment is due upon the time of your scheduled appointment or e-visit. PHW accepts most major credit and debit cards as preferred forms of payment. All patient billing inquiries should be directed to Physicians Billing Service.