Major changes coming to PHA in January 2025: CLICK HERE to learn more...
Insurance
We are transitioning from an insurance reimbursement-based practice to a direct pay practice in 2025. This means that we are terminating all insurance contracts and will no longer bill insurance after the date that your insurance company confirms that our contract with them has been terminated (“termination date”).
Visits will still be billed to insurance until your specific termination date. See the current termination status of our insurance contracts below.
After termination, all medical care provided to both members and non-members will be fee-for-service.
(Click here to learn more about which services will be available to members/non-members.)
Out-of-Network Benefits:
Once contracts are terminated, we will be considered “out-of-network providers”.
If you would like to submit claims to your insurance yourself for possible reimbursement, we recommend you contact your insurance and clarify your out-of-network benefits.
In addition to asking about how they cover out-of-network office visits, in-office procedures, and surgeries, we recommend asking about how medications, imaging, labs/bloodwork, and other testing ordered by an out-of-network provider are covered, if at all.
If desired, we can provide you with a detailed invoice for you to submit to your insurance yourself for possible reimbursement.
Insurance Contract Termination Status:
(updated 12/3/24)
Anthem Blue Cross Blue Shield: Tentative Termination Date: 2/4/25 (Confirmation Pending)
Including, but not limited to
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Blue Traditional
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Blue Access
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Blue Preferred
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Exchange
Beacon Health System: Termination Date 1/1/25 (Coverage through 12/31/24)
Including, but not limited to
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Aetna
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Allied Benefit System
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Employee Plans LLC
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Meritain
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Professional Benefit Administrators
Multiplan: Termination Date Pending
Including, but not limited to
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Key Benefit Administrators
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Medi-Share
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PHCS
Select Health Network: Termination Date 1/1/25 (Coverage through 12/31/24)
Including, but not limited to
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Aetna
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Auxiant
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CareSource Marketplace
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Cigna- HMO and PPO
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Encore
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Parkview Signature Care
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PHPNI
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Sagamore
Humana & Tricare East: Tentative Termination Date 2/17/25 (Confirmation pending)
United Healthcare: Termination Date 3/1/25 (Coverage through 2/28/25)
Including, but not limited to
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All Savers
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United Medical Resources (UMR)
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Veterans Administration (VA)
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Veterans Affairs CCN