Insurance & Payments
When you come to Pioneer Valley Surgical Associates for your appointment, please be sure to bring:
- Your insurance card
- Your driver’s license or state issued picture ID
- A method of payment for your co-pay, deductible or coinsurance portion
Insurance
It is always a good practice to confirm with your insurance carrier that we are an approved provider prior to scheduling an appointment. Our practice accepts most major insurance plans including:
- AARP
- Aetna PPO & Managed Care
- BMC Healthnet
- Blue Cross Blue Shield of MA and CT
- Medicare*
- Commonwealth Care Alliance
- ConnectiCare
- Tufts Health Plan
- Harvard Pilgrim
- Health New England
- United Healthcare
- HMO Blue, Blue Care Elect and Blue Care 65
- U.S. Healthcare
*You may have a co-pay and be required to sign an Advance Beneficiary Notice (ABN).
If you don’t have insurance, or if you are seeing us out-of-network, full payment is required at the time of your appointment. We also offer financing through Prosper Healthcare Lending.
If your appointment is due to a Workers’ Comp claim, you will need to provide all of the necessary information in advance of your appointment, including your case number, adjuster’s name, address and phone number, contact information for your employer and a description of the incident and the date of injury.
Co-Payments
Co-payments are fixed amounts set by your insurer and are your financial responsibility. Co-pays are due when you arrive for your appointment. At Pioneer Valley Surgical Associates, we accept payment by cash, debit card, personal check, and Mastercard, VISA, Care Credit or Discover. If you do not have your co-pay, your appointment will be cancelled and rescheduled.
Co-Insurane & Deductibles
Co-insurance is a percentage of the cost of the office visit, procedure or operation. Most plans are 80 percent paid by the insurance company and 20 percent is paid by you, the member.
Deductibles can range from $500 to $10,000. You must pay this amount out-of-pocket before your insurance company will start to provide coverage.
If you are unsure about your coverage, contact your insurance company in advance to determine how much you will be responsible to pay.
You must pay your co-insurance or deductible amount at the time of your office visit or before your operation. If you need surgery, our billing advisor and/or practice administrator can advise you according to our policies and your insurance requirements. We also offer financing through Prosper Healthcare Lending.
Insurance Coverage for Weight Loss Surgery
If you are considering weight loss surgery, call your insurance provider to see what bariatric surgery procedure they cover. You should also ask what requirements you must meet in order to a claim for approval, and what steps you can take if your request is denied. We can assist you with the denial process.
Referrals
Before you schedule an appointment, we recommend you check your insurance plan to see if you need a referral from your primary care provider to see one of our surgeons. If you need a referral but don’t obtain one, we will ask you to sign a waiver saying that you agree to be responsible for the cost of the office visit.