Participating Health Plans
Potomac Health & Wellness participates with most Blue Cross Blue Shield (BCBS) PPO health plans. Potomac Health & Wellness is also a certified Humana TRICARE East non-network, non-participating provider. We do not participate with any other health plans, including Aetna, Assurant, Cigna, GEHS, Humana, United Healthcare, health maintenance organization (HMO), point of service (POS), exclusive provider organization (EPO), Medicare, Medicaid, etc. - all considered non-participating health plans.
NOTE: Some non-PPO BCBS plans (e.g. BlueChoice Advantage) have a indirect or triple option PPO benefit, which Potomac Health & Wellness may participate with. Some non-PPO BCBS plans may have a opt out open access, with a out of network provider benefit, which Potomac Health & Wellness does not participate with.
- For all BCBS PPO health plans patients, who have met their current calendar year deductible, you are solely financially responsible for all of your assigned office visit co-pays, co-insurances, deductibles, account balances, etc., due at the time of your appointment. Our office will submit your office visit claims directly to your specific participating BCBS PPO health plan.
- For all BCBS PPO health plans patients, who have not met their current calendar year deductible, you must self pay for each office visit, until your deductible has been 100% met, due at the time of your appointment. We offer simplified, affordable office consultation fees and we provide office visit claims documentation for you to submit to your specific participating BCBS PPO health plan for self-reimbursement.
- For all uninsured, self pay, Humana TRICARE East, and non-participating health plans patients, you must self pay for each office visit due at the time of your appointment. We offer simplified, affordable office consultation fees and we provide office visits claim documentation for you to submit to your non-participating health plans for reimbursement.
NOTE: Office consultation fees are not inclusive of any additional incurred health care or administrative services (e.g. medical records or medical documentation review, medical record fees, third party patient forms, disability determinations, dietary counseling, special reports, etc.), which are an additional charge, ranging from $25-$250, due at the time of your scheduled appointment. All patients are 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 your specific healthcare insurance plan. Payment is due upon the time of your scheduled appointment. Our office accepts only major credit and debit cards as forms of payment. All patient billing inquiries should be directed to Physicians Billing Service.
FYI: Our provider was previously affiliated with Inova Urgent Care that resulted in two distinct organization-specific, provider health plan participation profiles:
- Inactive Profile: Inova Urgent Care participates with a wide network of health plans.
- Active Profile: Potomac Health & Wellness participates with most BCBS PPO health plans only.
This previous dual profile arrangement was confusing to new patients, because unfortunately many health plans did not, and may still not, make the organization-specific distinction to their members. Therefore, it is always best to contact our office, before scheduling your initial appointment, to verify whether Potomac Health & Wellness participates with your specific health plan, and if not, to find out what your available options are.
Potomac Health & Wellness
Select Participating PPO Health Plans