MAGNACARE

    • LVDI is considered in network as of 1/1/13 if card has Valley Preferred on it. 
    • Call the number on the back of the patient's card for information about referral or auth needs.
  Call number on back of card to find out. Plan Related-call number on back of card

MED Link

    • LVDI does not accept as primary insurance plan
 

MEDICARE

    Provider ID: 563802
 

MEGA LIFE

    Provider ID: MEGA LIFE

    THRU DEVON HEALTHCARE 

    • IF VALLEY PREFERRED is not located on the card LVDI is considered out of network.
    • Plan related-provider must call plan
 

MedPLUS (Unison)

    Provider ID: 82693
    • Unison no longer exists. See UHC.
 

Medicaid also known as Medical Assistance

     

    •  There are several medical assistance plans. See list below. The most common Medicaid plan is ACCESS (also known as traditional MedAssitance (Yellow Access Card)
    • No authorizations secondary to Medicare
    • Access card can be used with another insurance card- ASK IF PATIENT HAS AN ADDITIONAL CARD
    • See "A" for Access for provider number
 Keystone Mercy Health Plan - Out of network referral required Capitated - Out of network referral required Yes CT, PET and CTA
 Gateway Plan Related-Call Yes CT, PET and CTA
 ACCESS (traditional Yellow Card) No Yes-CT's, CTA's and PET scans
 Coventry Cares NOT IN PAR NOT IN PAR
 CHIP (children's) No Ask what plan it is through-check with that plan
 United Healtcare Community Plan NO NO
 AmeriHealth Northeast No Yes-see AmeriHealth Northeast for phone # to call
 AmeriHealth Caritas (formally AmeriHealth Mercy) No Yes CT, PET and CTA

Medicare Replacement Plans

    • Medicare Replacement plans take the place of Medicare.  Patients and/or Offices may still say Medicare and the replacement plan.  However, Medicare really no longer exists.
    • Most of these plans do require precertification for  CTs however see grid  for detailed information as some do not.
    • As of Jan 1, 2012 Keystone 65 Advantage HMO no longer exists. Pt's had to choose between Keystone 65 Select HMO and Keystone 65 Preferred HMO.
    • LVDI and LVHN is NOT IN PAR with Keystone 65 Select HMO.
    • Both the Keystone 65 Select and Preferred have a "YXI" prefix ask offices if the word "Select" is on the card.
 Sterling Options No No
 Aetna Golden Choice No No
 Keystone Senior Blue (Cap Blue) No Yes
 Geisinger Health Plan Gold No Yes- CT
 Personal Choice 65 (IBC) No Yes- CT, PET and CTA
 Advantra Freedom (NOT Advantra HMO/PPO) No No
 American Progressive NO NO
 Unicare Security Choice Enhanced No No
 Evercare no Plan related-must call
 HUMANA GOLD CHOICE NO NO
 UHC Medicare Advantage PPO No Plan Related
 Secure Horizons NO Yes
 AARP Medicare Complete Secure Horizons No Yes
 Keystone 65 Select LVHN Not in Par LVHN Not in Par
 Keystone 65 Preferred HMO Yes. If cap'd elsewhere, out of network referral is needed. Yes-CT, CTA's, PET's
 Keystone 65 Choice POS Yes. If cap'd elsewhere a out of network referral is needed. Yes-CT, CTA's, PET's
 Universal Healthcare PFFS No No
 Universal Healthcare HMO YES-may be capitated call 1-877-661-3920 YES-may be capitated call 1-877-661-3920
 Universal Healthcare PPO/POS No-however, if capitated will have a higher out of pocket payment Yes-if capitated will pay more out of pocket
 Gateway Assured (Medicare Assured) No-only script from office No
 Freedom Blue (Highmark) No Yes- CT only if body part is Head, Sinus, Chest, Abd or Pelvis. And CTAs and PETs

Medicare Supplement Plans

 Signature 65 No No
 Security 65 No No
 Railroad Medicare See Palmetto GBA No No
 Mutual of Omaha No No
 HOP No No
 Hartford Life Insurance No No
 Standard Life No No
 Al iCare Prime GE Financial Assitance No No
 USSA Life No No
 65 Special No No
 MediGap Blue No No
 GE Financial Assurance No No
 GEM Group/Steamfitters No No
 Humana NO NO
 United American NO NO
 Conseco NO NO
 Continental Life NO NO
 State Farm NO NO
 GEHA NO NO
 New Era Life No No
 Secure Horizons Medicare Supplement thru UHC No No

Meritain

    • This is a plan that should also say Aetna and Valley Preferred on the card.
    • Per Meritian, offices are to call Coordinated Healthcare at 1-800-247-8956 to check for auth.
    • Website is www.chc-care.com
 Meritain Aetna Valley Preferred NO Plan Related-see note above

MultiPlan

    •  Call the number on the back of the patients ID card for precert if needed
 MultiPlan PPO No Plan Related-Call

Mutual of Omaha

    •  Only accept this insurance as secondary to Medicare,  LVDI does not accept this insurance as primary as it would go through PHCS and we are not in par.
 MediCare Supplement Plan No No