Insurance & Payment
Patient insurance requiring a PCP selection must contact their insurance to change the practice selection to a specific provider selection using the TIN and Group NPI
Tax ID # 54-0967672 Group NPI # 1083793525
Plans we accept:
- Aetna (HMO and PPO)
- Aetna Innovation Health
- Anthem (HMO and PPO)
- Anthem Health keepers Plus (Medicaid MCO) *
- Care First (HMO and PPO)
- Champ VA (Courtesy File)
- Cigna (HMO and PPO)
- Cigna Connect
- First Health/PHCS
- Humana
- Johns Hopkins (US Family Health and EHP)
- MediNcrease
- Multiplan
- Prime Health Services
- Sentara Health Plan
- Sentara Community Plan (Medicaid MCO) *
- Student Resources (UHC)
- Tricare
- United Healthcare (HMO and PPO)
- United Healthcare Community Plan (Medicaid MCO) *
- Virginia Health Network
- Virginia Medicaid
- Web TPA
Plans we DO NOT accept:
- Kaiser (HMO)
- Aetna Better Health of Virginia (Medicaid MCO)
- Humana Healthy Horizons of Virginia (Medicaid MCO) *new as of 7/1/25
- Molina Care (Medicaid MCO) *sunsetting 6/30/25
- Sentara Community Plan Kaiser
- Department of Veterans Affairs
- Liberty, Trinity, Solidarity health share plans
*Not all locations are open to new Medicaid patients. Please reference the Medicaid Panels by Practice document for more information.
Updated 6/20/25
Well Check Appointment
Copayment or No Copayment?
Even if a physical or preventative test is fully paid by insurance, you may STILL have a copayment/coinsurance/deductible for the visit.
See explanation below:
Your child’s Well Check (Physical), which includes a routine physical examination, routine labs, routine vision or hearing and routine immunizations normally does NOT require a copayment.
HOWEVER, if you discuss concerns or symptoms of acute or chronic conditions or a problem-oriented condition is discovered during the well check, it is considered “diagnostic” and you will most likely be required to pay a copayment/coinsurance/deductible if applicable.
Example:
An appointment is scheduled for a Well Check (Physical).
During the physical, you express concern(s) and are treated for an un-related problem: symptoms of acute illness (cold, cough, ear pain, rash etc), concerns about an uncontrolled chronic condition (ADHD, skin problems, weight issues, etc) or requesting changes to medications.
In compliance with insurance company billing policies this prompts charges for both categories which require a copay or coinsurance/deductible, should you have one.
