Insurances

The surgeons of Pioneer Valley Surgical Associates are participatory providers in many of the major health insurance plans including:

The agreement of the insurance company to pay for medical care is a contract between you and the company, not between the company and your physician.

  • Aetna PPO & Managed Care
  • BMC Healthnet
  • Blue Shield of MA and CT
  • Medicare
  • ConnectiCare
  • Tufts Health Plans
  • Harvard Pilgrim Health Plans
  • Health New England
  • United Healthcare
  • HMO Blue, Blue Care Elect and Blue Care 65
  • U.S. Healthcare
  • as well as many others
  • If we do not participate with your plan, we will be more than happy to see you, however, an out-of-plan referral will be needed.
  • We will provide Second surgical opinion
  • Please contact your insurance company to follow their requirements for a specialty services.
  • It is the patient's responsibility to understand the administrative and financial responsibilities of their insurance plan.
  • We will always ask to see a copy of your insurance card at every office visit with us.

Payment

For your convenience, cash, personal checks, Mastercard, Visa, Debit and Discover are accepted for your insurance copay, plan deductibles and or co-insurance.

It is your responsibility to pay any deductible amount, co-insurance, or any other balance not paid by your health plan. A disclosure of fees is available at any time. We will be happy to help you receive maximum benefits.

The agreement of the insurance company to pay for medical care is a contract between you and the company, not between the company and your physician. We know questions can arise concerning insurance matters and billing procedures.

Billing questions please call (413) 736-3163, EXT. 313 between 9:00 a.m. and 3:00 p.m.

Co-Pay

You are responsible for your co-pay at the time of your office visit. We will cancel your appointment if you do not have this payment available at the time of your office visit unless your visit is considered an emergency. This will be determined by the practice administrator and your surgeon.

Co-Insurance

In health insurance coinsurance is sometimes used synonymously with copayment but is defined differently - a copay is typically fixed while the coinsurance is a percentage that the you pay after the insurance policy's deductible is exceeded up to the policy's stop loss. It is expressed as a pair of percentages with the insurer provider portion stated first. The maximum percentage the insured will be responsible for is generally no more than 50%. Once your out-of-pocket expenses equal the stop loss the insurer will assume responsibility for 100% of any additional costs. 70-30, 80-20, and 90-10 insurance provider and you coinsurance plans are very common, with stop loss limits of $1,000 to $3,000 after which the insurance provider covers all expenses.

PVSA requires a copy of your debt and or credit card for the amount that you are responsible for. If you require surgery we will determine what the amount of your coinsurance plan will be and collect it prior to surgery. Once your EOB (explanation of benefits) is available we will either refund or bill you for the remaining portion of the claim.