Insurance Information

Our practice accepts most major insurance plans and most of the smaller insurance plans. If we do not participate with your insurance and your plan allows out of network benefits, our office staff will assist you with the necessary paperwork so you can receive reimbursement directly from your insurance company.

If you do not see your insurance listed below, please call the office to speak with one of our knowledgeable staff members about your individual coverage.

Pioneer Valley Urology, P.C. participates with the following insurance programs:

• Aetna
• Allways Health Partners
• Anthem Blue Cross Blue Shield
• Blue Cross Blue Shield of Massachusettss
• BMC Healthnet
• Celticare
• Cigna
• CommonCare Alliance
• Connecticare
• Consolidated Health Plans
• Coventry
• Fallon
• Harvard Pilgrim Healtcare
• Healthnet
• Health New England
• Humana
• Mass Health
• Medicare
• Network Health
• Pace Mercy Life
• Pace Serenity Care
• Senior Whole Health
• Tufts Health Plan
• Tufts Network Health
• Unicare
• United Healthcare
• U.S. Family Health Plan

The above list of insurance plans is provided as a reference for patients. Please contact your insurance plan directly to verify that Pioneer Valley Urology is in your plan’s network. Insurance carriers offer many different plan options, so it is important that patients understand their benefits. Patients are encouraged to contact their insurance plan’s member services department with any questions related to coverage, cost sharing, referrals, or other requirements. Pioneer Valley Urology’s participation in a plan’s network is not a guarantee of coverage, and patients are responsible for any costs that are not covered by the plan.

If Pioneer Valley Urology is not included in your plan’s network, please contact our office to make payment arrangements prior to your scheduled appointment. Patients may be able to obtain healthcare services at a lower cost from a healthcare provider who participates in your health plan.

As your healthcare provider, our focus is on providing you with the highest quality urologic care possible. Our providers use the most current medical technology available to assist with diagnosing and treating urologic conditions. In order to be able to deliver this level of service, it is necessary to collaborate with other healthcare professionals, who are specially trained and qualified to interpret test results. We want you to be aware that these professionals may also submit claims to your insurance company for the services they provide.

Definitions

Referral

Your insurance plan may require an insurance referral before seeing a specialist. It is your responsibility to obtain the proper referral, prior to your appointment, in order to be seen for your appointment. If you do not have a referral at your appointment time, your appointment will be rescheduled. The patient will be responsible for services denied by insurance due to “No Referral Obtained”.

Deductible

Is the amount of health care services you must pay for before your insurance company pays anything. Patients may be responsible for the entire cost of services if they have not met their plan's deductible.

Co-Payment

Is the cost for routine services for which your dedcutible does not apply. Co-payments are required before services are rendered.

Co-insurance

The amount you must pay for services after you have met your deductible.

Out of Pocket Maximum

The absolute maximum amount you'll pay in a plan year.