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Insurance & Fees

The following is the list of insurances with which we participate. This will be updated from time to time as needed:

  • Aetna
  • Alignment Health Plan
  • Anthem Blue Cross of California
  • Blue Shield California
  • Cigna
  • Connect Care Cigna Subsidiary
  • Coventry
  • Dignity Health
  • Employer Direct Healthcare
  • Healthnet
  • HealthNet Federal Services
  • Healthsmart
  • JADE/CCHP
  • Medicaid (Medi-Cal)
  • Medicare
  • Multiplan
  • Networks by Design
  • NX Health Network
  • On Lok Lifeways
  • Palo Alto Medical Foundation (Sutter Health)
  • Railroad Medicare
  • Seoul Medical Group
  • Seven Corners
  • Tricare HealthNet Federal Services
  • TriWest Healthcare Alliance
  • United HealthCare of CA

*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.

Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.


Payment Options

We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.


Card-on-File

We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.

At check-in we will:

  • scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card

After your insurance has paid their portion, we will:

  • notify you via email of the balance owed
  • charge the balance owed to your card on file
  • email a receipt for the charge

Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).


Fees

No Shows
Missed Appointment $50
Missed Physical $100
Late Cancellation $50
Missed Procedure $200

Out-Of-Network
New Patients Total Charge or Minimum $200 Deposit
Established Patients Total Charge or Minimum $150 Deposit

Self-Pay
New Patients Total Charge or Minimum $200 Deposit
Established Patients Total Charge or Minimum $150 Deposit
Procedures Total Charge or Minimum $200 Deposit

NOTE: Please be aware that we will make every attempt to bill your health insurance company for our services. However, in the event that your health insurance company denies our claim for any reason, or assigns the allowed charges to your annual deductible or co-insurance, or if you do not have health insurance, you will be responsible for charges ranging from $200 to $750 depending on the services provided.

As a specialty medical practice, we may need to perform diagnostic procedures, testing, and/or therapy during your visit in the best interest of your care. Procedures/testing/therapy will be billed separately and may not be included in the cost of the standard office visit with our physician. 

Please call your insurance company in advance of your appointment and give them our NPI (1578996906) and the following frequently used Common Procedural Terminology (CPT) codes listed below for the procedures/testing/therapy that may occur during your visit. You will want to determine if these services are covered and if so, how much you may be required to pay out of pocket based on your individual plan’s co-insurance and deductible.

Frequently Used CPT Codes

  • X-Ray: CPT Code 73610/ 73630
  • Wart Removal: CPT Code 17110/ 17111/ 11420/ 11421/ 11422
  • Ingrown nail procedure: CPT Code 11730/ 11750
  • Taping: CPT Code: 29540
  • Injection: CPT Code 20605/ 20600/ 20612/ 64450/ 11900/ 20551/ 20550/ 20552
  • Biopsy: CPT Code 11100/ 11755/ 10021
  • Custom orthotics: L3000/ 97760/ 97762