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Billing & Insurance

Payment of fees for medical and surgical care is the direct responsibility of the patient. Please be prepared to take care of your account at the time of service.

We participate in most major health insurance plans and will file insurance claims on your behalf. Co-payments will be collected at the time of service. Please remember that insurance claims and benefits are matters involving you and your insurance carrier. Although we are happy to assist you in these matters, it is the patient’s responsibility to understand the requirements of his or her insurance policy and to plan accordingly.

For all plans in which we participate: We will submit a claim (CMS1500) for the patient. The patient is responsible for the applicable co-payment/deductible per their insurance plan.

Otolaryngology Associates, P.C. participates with the following insurance plans:

  • Aetna (Managed Care, Select Choice, HMO, PPO, EPO, Open Access, POS)
  • Aetna Aexcel (Please be sure to contact your carrier in advance regarding your benefits for out-of-network coverage)
  • Carefirst (FEP, PPO, BlueChoice & NASCO)
  • Anthem (Blue Cross of Virginia) (excluding HealthKeepers)
  • Community Care Network (CCN)
  • First Health
  • Medicare
  • MultiPlan/Private Healthcare Systems (PHCS), including Unicare and NCPPO
  • Mamsi, including Optimum Choice & MDIPA
  • One Health
  • United Healthcare (HMO, PPO, EPO, POS)
  • OneNet (formerly Alliance PPO)
  • Tricare (Accepting patients beginning September 2010)

We reevaluate participation in various insurance plans from time to time. If your plan is not listed or you have questions concerning the above information, please contact our office at (703) 383-8130.

For all plans in which we DO NOT participate: You will be required to pay our charges in full at the time of service. It is your responsibility to submit claims to the insurance company for reimbursement on all office visits, testing, and procedures. If you need to have surgery, either at an outpatient facility or in the hospital, we will verify your out-of-network benefits and submit the claim (CMS 1500) to your insurance company (if permitted) for direct payment to our practice. You will, however, be responsible for any unpaid balance, co-payments, or deductibles.

We do not participate in the following insurance plans:

  • Medicaid
  • Kaiser
  • Anthem HealthKeepers

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