Insurance Fees
Insurance & Fees
The following is the list of insurances with which we participate. This will be updated from time to time as needed:
- Aetna Commercial/Medicare
- Allegiance – Custom Ink
- Alterwood Health
- Anthem BCBS
- Apostrophe
- Bright Health
- CareFirst BCBS
- Cigna Healthcare
- ClaimDoc
- Flume Health/SavATree
- Humana
- Humana Military Tricare
- Lifeworks Advantage
- Medicare – Railroad
- Medicare – Virginia
- Medicare DC
- Multiplan/PHCS
- Sentara Health Plans – Commercial
- United Healthcare
- Virginia Health Network
- WPS Certification (Humana Mil Tricare)
*We are currently not taking Medicaid*
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).
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 |
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)
Additional Patient Forms
Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
Springfield Office
5510 Alma Ln STE 110, Springfield, VA 22151
Woodbridge Office
2200 Opitz Blvd Ste 320, Woodbridge, VA 22191
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