Alyssa Lane
When it comes to insurance coverage, Valley Medical Center and Valley Medical Group are separate entities with different accepted insurance plans. Valley Medical Center provides billing and insurance information, including payment options and claims submission. They also specify that they will bill the Washington State Department of Labor and Industry or other self-insured workers' compensation programs. Valley Medical Group, on the other hand, has a list of accepted insurance plans, including major providers such as Aetna, Cigna, and United HealthCare. It is important to verify coverage with your specific insurance plan, as insurers may offer varying options and restrictions.
| Characteristics | Values |
|---|---|
| Insurance plans accepted by Valley Medical Group | Aetna (excluding Aetna Better Health Medicaid HMO), Amerihealth Braven Health (Except Braven Medicare Plus (HMO)), Cigna (including Medicare), Clover Centivo, Horizon BCBS, United HealthCare, Veterans Administration Community Care Network (CCN), Beech Street Community Care Network, Consumer Health Network (CHN), Devon Health Services, First Health, Health Care Payors Coalition, MagnaCare, Multiplan, NJ Urology Group (administered by HealthScope), Qualcare |
| Insurance plans accepted by Valley Health Care Centers | Aetna (HMO and PPO), Aetna (LBP), Aetna (MA), Aetna Passport (International), Aetna QHP Excha |
| Insurance plans accepted by Valley Medical Center | N/A |
| Other notes | Valley Medical Center will bill the Washington State Department of Labor & Industry, or other Employer Self Insured Workman’s Compensation programs. Patients are advised to check with their insurance provider to determine a healthcare provider’s network status. |
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What You'll Learn
Valley Medical Center billing and payment procedures
Billing and insurance procedures at Valley Medical Center vary depending on the specific Valley Medical Group location and the insurance plan in question. It is the patient's responsibility to check with their insurance provider to determine a healthcare provider's network status.
Valley Medical Center offers several ways to pay your bill. Any services provided by contracted providers, such as surgeons, radiologists, anesthesiologists, and pathologists, will be billed separately by the physician's billing office. You may receive informational statements while your insurance company processes your claim, but you will not be required to make a payment until your portion of the services is determined and sent to you in the form of a bill. If your visit is the result of a motor vehicle or non-work-related accident, you will be required to provide all automobile insurance or other third-party liability information within 15 days.
If you have questions about your bill or statements received, you can contact Valley Medical Center's Patient Financial Services (PFS) department at 1.855.826.1540 or 425.690.3578, option 5.
Valley Medical Center will bill the Washington State Department of Labor & Industry, or other Employer Self-Insured Workman's Compensation programs. They will provide information about your accident and health status within the legally required time frames so that you can receive any time-loss payments or other benefits associated with work-related incidents.
If you have any questions regarding your insurance plan's participation status with Valley Health, you can contact their Payer Contracting team at [email protected] or 540-536-6140. Insured individuals should check with their employer's benefits manager, broker, or plan manual to ensure they are accessing care through their plan option's preferred providers to receive the highest benefit level.
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Insurance plans accepted by Valley Medical Group
It is important to note that insurance plans accepted by Valley Medical Group may vary by location and are subject to change. Therefore, it is recommended that patients contact their insurance carrier or the provider's office for confirmation.
- Horizon BCBS (VPS, Inc./PC is Tier 1 in Omnia, including Commercial and Medicare LOB, and Medicaid)
- Aetna (excluding Aetna Better Health Medicaid HMO)
- Amerihealth Braven Health (excluding Braven Medicare Plus (HMO))
- Cigna (including Medicare)
- Clover Centivo
- Horizon Blue Cross Blue Shield of NJ
- Horizon NJ Health
- Mohawk Valley Health Plan (non-HMO plans only via Valley's CIGNA contract)
- Great-West Healthcare (now part of CIGNA)
- Oxford Health Plans
- United HealthCare (including United HealthCare Community Plan)
- Veterans Administration Community Care Network (CCN)
- Beech Street Community Care Network
- Consumer Health Network (CHN)
- Devon Health Services
- First Health
- Health Care Payors Coalition
- MagnaCare
- Multiplan
- NJ Urology Group (administered by HealthScope)
- Qualcare
It is important to remember that insurance companies have limits on the services they cover, and patients should be aware of their membership eligibility, benefits, limitations, and exclusions under their specific plan. If a patient's insurance plan is not in-network with Valley Medical Group, the financial obligation for any services received remains the patient's responsibility.
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Valley Health System insurance plans
The Valley Health System comprises The Valley Hospital and Valley Medical Group, which contract separately with insurers. It is the patient's responsibility to check with their insurance provider to determine a healthcare provider’s network status.
The Valley Hospital accepts the following insurance plans:
- Aetna (HMO and PPO)
- Aetna (LBP)
- Aetna (MA)
- Aetna Passport (International)
- Aetna QHP Exchange
- TRICARE®
The Valley Medical Group accepts the following insurance plans:
- Aetna (excluding Aetna Better Health Medicaid HMO)
- Amerihealth Braven Health (Except Braven Medicare Plus (HMO))
- Cigna (including Medicare)
- Clover Centivo
- Horizon Blue Cross Blue Shield of NJ
- Horizon NJ Health
- Mohawk Valley Health Plan (non-HMO plans only via Valley's CIGNA contract)
- Great-West Healthcare (now part of CIGNA)
- Oxford Health Plans
- United HealthCare (including United HealthCare Community Plan)
- Veterans Administration Community Care Network (CCN)
- Beech Street Community Care Network
- Consumer Health Network (CHN)
- Devon Health Services
- First Health
- Health Care Payors Coalition
- MagnaCare
- Multiplan
- NJ Urology Group (administered by HealthScope)
- Qualcare
It is important to note that insurance companies have limits on the services they cover, and patients should be aware of their membership eligibility, benefits, limitations, and exclusions under their specific plans. Valley Medical Group will submit a bill to the patient's carrier as a courtesy if they do not participate with their insurance plan, but the financial obligation remains the patient's responsibility.
If you have any questions regarding your insurance plan’s participation status with Valley Health, you can contact their Payer Contracting team at [email protected] or 540-536-6140.
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Valley Medical Center billing for out-of-network providers
Valley Medical Center offers a range of billing and insurance options for its patients. The center provides billing and insurance information on its website, including details on accepted insurance plans and out-of-network providers.
In terms of billing, Valley Medical Center offers a self-pay discount and uninsured and prompt-pay discounts. Patients can contact the Patient Financial Services department to discuss payment options and assistance with patient balances. The center also provides charge estimates in advance of care, although these are estimates and the final billing amount may differ.
Regarding insurance, Valley Medical Center accepts various insurance plans, including Aetna (excluding certain plans), Amerihealth Braven Health (with some exceptions), Cigna (including Medicare), and Horizon Blue Cross Blue Shield of NJ, among others. It is important to note that insurance plans accepted by the Valley Medical Center may differ from those accepted by The Valley Hospital, as they contract separately with insurers.
In cases where patients receive treatment from out-of-network providers, they are protected from balance billing, also known as "surprise billing." This means that patients will not be charged more than their plan's copayments, coinsurance, and/or deductible. However, it is the patient's responsibility to understand their insurance coverage and network status. If Valley Medical Center does not participate with a patient's insurance plan, they will submit a bill to the carrier as a courtesy, but the financial obligation remains the patient's responsibility.
Overall, Valley Medical Center strives to provide clear and transparent billing and insurance information to its patients, offering a range of payment options and protections against surprise billing. Patients are encouraged to review their insurance coverage and contact the center's billing and insurance departments for more detailed information.
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Valley Medical Center billing for accidents
Billing and insurance are important considerations when seeking healthcare. Valley Medical Center (VMC) offers several payment options and provides billing support to its patients.
VMC accepts a range of insurance plans, and it is important to check with your insurance provider to determine if VMC is in-network. VMC bills all insurances if complete billing information is provided. If you are uninsured, VMC offers uninsured and prompt-pay discounts. You can contact VMC's Patient Financial Services to discuss payment options and assistance with patient balances.
VMC provides a brochure with detailed information about the billing process, including submitting claims, payment options, and bills from other providers. It is important to note that services provided by contracted providers, such as surgeons, radiologists, and anesthesiologists, will be billed separately by their respective billing offices.
In the case of emergency care or treatment by an out-of-network provider at an in-network facility, you are protected from balance billing, also known as "surprise billing." In these situations, you should only be charged your plan's copayments, coinsurance, and/or deductible.
VMC offers multiple ways to pay your bill, including online through their patient portal, by phone, or through various accepted payment methods, such as cash, check, or credit card. If your insurance does not cover the full amount, you may be required to pay an estimate of your portion of the bill at the time of service, and the hospital will file the claim for you. You may also be able to arrange monthly payments with the hospital until your bill is paid in full.
It is always essential to understand your insurance coverage, including any deductibles or copayments, to ensure you can meet your financial obligations. If you have any questions or concerns about your bill, VMC's Patient Financial Services and Account Representatives are available to provide assistance.
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Frequently asked questions
Valley Medical Center accepts insurance plans from providers including but not limited to Aetna, Amerihealth, Cigna, Horizon BCBS, and United HealthCare. The Valley Hospital and Valley Medical Group contract separately with insurers, so it is recommended to check with your insurance provider to determine a healthcare provider’s network status.
You can check if Valley Medical Center accepts your insurance by contacting their Payer Contracting team at [email protected] or 540-536-6140.
If Valley Medical Center does not accept your insurance, they will submit a bill to your carrier as a courtesy, but the financial obligation remains your responsibility.
If you have questions about your bill, you can contact Valley Medical Center's Patient Financial Services (PFS) department at 1.855.826.1540 or 425.690.3578, option 5.
