Insurance

Insurance & Billing

We participate in most insurance plans.

If your insurance company requires a referral from your primary care physician, please be sure to bring that referral to your appointment. Failure to bring your referral may result in your appointment being rescheduled.

All office visits are expected to be paid at the time of your appointment, unless you have an insurance provider with which we are participating. Co-pays and fees for non-covered services will be collected at the time of service.

For your convenience we accept cash, personal checks, VISA MasterCard, American Express & Discover Card. If you have questions pertaining to billing, please contact our office.

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In-Network Insurance Payers

Respiratory Specialists is in-network for office visits with the following insurance payers. It is the patient's responsibility and we recommend that you confirm that we participate with your insurance.

If you don't see your plan listed, please contact our office. The managed care health insurance market changes rapidly, and specific coverage questions should be discussed directly with your insurance company or our knowledgeable staff.

• AETNA
• AMERIHEALTH CARITAS (MEDICAID)
• AMERIHEALTH CARITAS NE (MEDICAID)
• AMERIHEALTH VIP CARE (PRIMARY)/AMERIHEALTH CHC (SECONDARY)
• AMERIHEALTH HMO & AMERIHEALTH ADMINISTRATORS
• CAPITAL BLUE CROSS
  • BlueJourney PPO (MEDICARE ADVANTAGE)
  • BlueJourney HMO (MEDICARE ADVANTAGE) - No Referral Needed
  • CareConnect
  • POS
  • Traditional PPO
• CIGNA
• CIGNA HEALTHSPRING (MEDICARE ADVANTAGE)
• DEVOTED HEALTH PLAN
• GATEWAY HEALTH PLANS - Currently HIGHMARK WHOLECARE (MEDICARE & MEDICAID)
• GEISINGER HEALTH PLANS (MEDICARE & MEDICAID) (HMO requires referrals) (FAMILY does not require referrals)
• HEALTH PARTNERS PLANS (MEDICAID) - Effective 1/1/24, Medicare is branded as JEFFERSON HEALTH PLANS MEDICARE HMO & PPO (plan name on card)
• HIGHMARK BLUE CROSS (Includes Premier Blue & Medicare Advantage)
• HUMANA
• INDEPENDENCE BLUE CROSS (Keystone 65/Personal Choice 65)
• INDEPENDENCE ADMINISTRATORS
• INTERGROUP (PPO)
• KEYSTONE HEALTH PLAN EAST (HMO requires referrals)
• KEYSTONE 65 (MEDICARE) - No Referral Needed
• LOOMIS
• MEDICAID-PA
• MEDICARE - DUAL (UPMC FOR LIFE, AH CHC, AH VIP CARE, WELLCARE BY ALLWELL)
• MULTIPLAN - Visit will be reported as Out of Network (when applicable)
• PA HEALTH & WELLNESS (MEDICAID)
• RAILROAD MEDICARE (administered by Palmetto GBA)
• TRICARE (POS) - (PRIME/SELECT/FOR LIFE-retirees) Patient can be scheduled needs to be advised that visit will go through point of service (POS) meaning patient will have higher out of pocket expense.
  ACTIVE DUTY IS NOT SEEN - REFERRAL NOT OBTAINABLE DUE TO OUT OF NETWORK STATUS
• UNITED HEALTHCARE - Commercial / Medicare (including AARP) / VA CCN
• UNITED HEALTH COMMUNITY PLAN - MEDICAID/CHC-DUAL/CHIP
• UPMC - For You (MEDICAID) / For Life (MEDICARE)
• VIBRA HEALTH PLAN

Not In-Network & Not Accepting

Respiratory Specialists is not accepting the following insurance payers.

• CAPITAL BLUE CROSS - VALLEY ADVANTAGE EPO
• UNITED HEALTH CARE OXFORD
• MAGNACARE
• KEYSTONE FIRST - ONLY POTTSTOWN AREA