Insurance Information
We are in network with most insurance plans and referrals are generally NOT required(unless required by your insurance). However, insurers that offer HMO (gatekeeper) products may place restrictions on where patients can receive certain outpatient services (i.e., lab services, radiology, physical/speech/occupational therapy). It is a patient's responsibility to know your plan's specific requirements and restrictions. If you are not sure about your benefit plan details and requirements, please speak with your insurance company before making an appointment.
*Using the number on the back of your insurance card, call your plan directly to verify network status, plan requirements and out of pocket expenses (IE. your copay, deductible and coinsurance) by providing them our group NPI (National Provider Identifier), which is NPI# 1215596135.*
*Using the number on the back of your insurance card, call your plan directly to verify network status, plan requirements and out of pocket expenses (IE. your copay, deductible and coinsurance) by providing them our group NPI (National Provider Identifier), which is NPI# 1215596135.*
Aetna Commercial plans
Aetna Medicare
Amerihealth Caritas NC (NC Medicaid Managed-Care Plan)
Appalachian Benefit Associates
Blue Cross Blue Shield PPO, Indemnity and Blue Value plans(effective 10/16/2023)-'specialist' copays apply
BLUE MEDICARE(effective 10/16/2023)
BWC (Bureau of Workers Compensation)
Carolina Complete Health (NC Medicaid Managed-Care Plan)
Cigna PPO
Cigna Open Access
Cigna Healthspring
Coventry
Crescent
Devoted Health(effective 01/01/2024)
Friday Health plans
Healthgram
Healthy Blue (NC Medicaid Managed-Care Plan)
Humana/Choice Care Commercial plans
Humana/Choice Care Medicare Advantage HMO
Humana/Choice Care Medicare Advantage PPO
Humana/Choice Care Medicare Advantage PFFS
Medcost
Medicaid (North Carolina)
Medicaid (South Carolina, limited to the original SC Medicaid plan ONLY)
Medicare
ALL Medicare Supplement Plans
Multiplan
One Net PPO(Worker's Compensation)
Railroad Medicare
Tricare East SELECT
Tricare East PRIME 'Certified' Non-Network(deductibles and cost share applies)
Tricare for Life
TriWest (VA Community Care Network)-referrals from the VA are required !
Troy Medicare plans
United Healthcare, standard Commercial plans
United Healthcare Options PPO
Wellcare Medicaid (NC Medicaid Managed-Care Plan)
WellCare Medicare
Wellpath
WNC Health Coalition
Aetna Medicare
Amerihealth Caritas NC (NC Medicaid Managed-Care Plan)
Appalachian Benefit Associates
Blue Cross Blue Shield PPO, Indemnity and Blue Value plans(effective 10/16/2023)-'specialist' copays apply
BLUE MEDICARE(effective 10/16/2023)
BWC (Bureau of Workers Compensation)
Carolina Complete Health (NC Medicaid Managed-Care Plan)
Cigna PPO
Cigna Open Access
Cigna Healthspring
Coventry
Crescent
Devoted Health(effective 01/01/2024)
Friday Health plans
Healthgram
Healthy Blue (NC Medicaid Managed-Care Plan)
Humana/Choice Care Commercial plans
Humana/Choice Care Medicare Advantage HMO
Humana/Choice Care Medicare Advantage PPO
Humana/Choice Care Medicare Advantage PFFS
Medcost
Medicaid (North Carolina)
Medicaid (South Carolina, limited to the original SC Medicaid plan ONLY)
Medicare
ALL Medicare Supplement Plans
Multiplan
One Net PPO(Worker's Compensation)
Railroad Medicare
Tricare East SELECT
Tricare East PRIME 'Certified' Non-Network(deductibles and cost share applies)
Tricare for Life
TriWest (VA Community Care Network)-referrals from the VA are required !
Troy Medicare plans
United Healthcare, standard Commercial plans
United Healthcare Options PPO
Wellcare Medicaid (NC Medicaid Managed-Care Plan)
WellCare Medicare
Wellpath
WNC Health Coalition
Out of Network Plans
Some insurance plans are considered out of network due to plan limitations put into place by the insurance carrier. You will be charged at the time of service. If we were unaware or unable to collect at the time of service you will be balance billed and payment will be expected at your next appointment.
We CAN still file the claim to these payers, however, the claims will usually process to your out of network benefits/deductible. Please check with your insurance plan for more details. You can also always contact your insurance and request an exemption or you may request to 'nominate' our group directly with your insurance plan.
Some insurance plans are considered out of network due to plan limitations put into place by the insurance carrier. You will be charged at the time of service. If we were unaware or unable to collect at the time of service you will be balance billed and payment will be expected at your next appointment.
We CAN still file the claim to these payers, however, the claims will usually process to your out of network benefits/deductible. Please check with your insurance plan for more details. You can also always contact your insurance and request an exemption or you may request to 'nominate' our group directly with your insurance plan.
Aetna CVS plan(this is a limited network plan created & restricted by Aetna)
Bright Health (no longer offered in NC)
Friday Health Plans (no longer offered in NC)
HealthTeam Advantage plans (closed network-not offering participation to new/additional providers)
United Healthcare Medicare (closed network-not offering participation to new/additional providers)
Other out of state Medicaid plans (ie. TN, GA, VA even if they are managed by any of the payers in the list at the top of the page)
Bright Health (no longer offered in NC)
Friday Health Plans (no longer offered in NC)
HealthTeam Advantage plans (closed network-not offering participation to new/additional providers)
United Healthcare Medicare (closed network-not offering participation to new/additional providers)
Other out of state Medicaid plans (ie. TN, GA, VA even if they are managed by any of the payers in the list at the top of the page)