Billing and Insurance

Billing & Insurance

Let us assist you.

Your procedure is over, your stay with us has ended, but now you may have additional paperwork to fill out. We can help. From forms and financial questions to working with Medicare or your insurance provider, Pottstown Hospital is as passionate about assisting patients with what happens after a medical procedure or emergency as with the care that occurs during it. Use the information in this section to help the billing and payment process go smoothly.

Insurance

Pottstown Hospital, Pottstown Oncology Associates, and Pottstown Obstetrical Associates accept most major insurance providers. Contact Patient Billing at 833-341-5488 if you have questions about accepted insurance providers.

For a list of insurances accepted by Pottstown Hospital's Tower Health Medical Group practices, please visit our Tower Health Medical Group, Pottstown Hospital page.

Accepted Insurance

We accept all major health insurance and managed care programs, including:

Commercial Plans

  • Aetna
    • Aetna HMO
    • Aetna HMO (Open Access)
    • Aetna HMO / Health Network Only
    • Aetna QPOS
    • Aetna Savings Plus
    • Aetna Select
    • Aetna Signature
    • Aetna Value Performance Network
    • Aetna Voluntary Plans
    • Aetna Whole Health
    • Choice POS, Choice - POS (Aetna HealthFund), Choice POS II, Choice POS II (Aetna HealthFund)
    • Elect Choice EPO
    • Health Network Only & Health Network Option
    • International Medical
    • Managed Choice, Managed Choice - Open Access, Managed Choice POS
    • Mercy Preferred Choice POSII, Mercy Preferred Choice Select, Mercy Preferred Elect Choice EPO
    • Mercy Preferred Managed Choice & Mercy Preferred Open Choice (PPO)
    • Open Access - Elect Choice, Open Access EPO
    • Open Access POS, Open Access EPO Plus (Broad) & Open Access POS II (Broad)
    • Open Choice PPO & Open Choice PPO - Aetna HealthFund
    • Peak Preference Select HNOnly on the Altius Network and Peak Preference Select HNOption on the Altius Network
    • Preferred - Open Choice PPO, Preferred Choice POS II, Preferred Select
    • Preferred Elect Choice EPO, Preferred Managed Choice
    • Premier Care - Network & Premier Care Network Plus

    We do not participate in the following Aetna plans:

    • Not PEBTF HMO
  • Capital Blue Cross
    • CareConnect – PinnacleHealth ACA Network
    • Comprehensive
    • POS
    • PPO, PPO Choice
    • Traditional
    • HMO

    We do not participate in the following Capital Blue Cross plans:

    • Valley Advantage EPO
  • Coventry
  • Cigna
    • ChoiceFund OA Plus
    • Open Access Plus
    • OA Plus
    • ChoiceFund OA Plus with CareLink PPO
    • Choice Fund PPO Network
    • HMO
    • POS
  • Devon
  • First Health Network
  • HealthAmerica / Health Assurance
  • Independence Blue Cross
    • Keystone HMO Proactive (Tier 1)
    • Keystone HMO/POS/Direct POS
    • Personal Choice PPO
    • Personal Choice EPO
    • Personal Choice Tiered (Tier 1)
    • National BlueCard PPO
    • IBC HMO, PPO, EPO Commercial
    • AmeriHealth PPO & HMO Commercial
    • AmeriHealth Comprehensive Major Medical
  • All Physicians
  • Provider Partners Health Plan
  • United Healthcare
    • All Savers
    • Unitedhealthcare Catalyst
    • Unitedhealthcare Choice and Choice Plus
    • Unitedhealthcare Choice Advance and Choice Plus Advance
    • Unitedhealthcare Options PPO plans
    • Unitedhealthcare Tiered Benefit Plans
    • Unitedhealthcare MD-IPA Plan
    • Unitedhealthcare Navigate
    • Unitedhealthcare Student Resources
    • UHC Compass Rose PPO Plan

    We do not participate in the following United Healthcare plans:

    • Unitedhealthcare Navigate
    • Oxford (unless the member has access to choice plus)
    • Heritage (unless the member has access to choice plus)
    • Erikson Advantage
  • UPMC Health Plans
    • Premium Network Plans PPO and EPO Plans
    • UPMC Business Advantage HMO
    • Enhanced Access HMO and POS Plans
    • UPMC Employees Out of Area PPO Plan
      • UPMC Out of Area Gold
      • UPMC Out of Area Silver
    • Panther Gold HMO (For Pitt Employees)
    • FEHB Plans
    • MyCare Advantage PPO Level 2 Providers

    We do not participate in the following UPMC plans:

    • Partner Network Plans (HMO and EPO Plans)
    • Standard Network Plans (HMO Plans)
    • UPMC Business Advantage HMO (Referral Required)
    • UPMC Employees Advantage EPO Plans
    • Panther Gold Advantage HMO (For Pitt Employees)
    • UPMC Inside Advantage Level 1 Providers
    • MyCare Advantage HMO Level 1 Providers
    • MyCare Advantage HMO Level 2 Providers
    • MyCare Advantage PPO Level 1 Providers

Medicaid HMO

  • Aetna Better Health
  • Gateway Health Plan
  • Keystone First
  • UHC Medicaid
  • UPMC Community Health Choices
  • UPMC for You HMO

Medicare Advantage

Plans Offering Drug Coverage

  • AARP Medicare Complete
    • HMO
    • Choice PPO
  • Aetna Medicare
    • Choice HMO
    • Silver HMO
    • Gold PPO
    • Main Line Health Prime HMO
    • Premier HMO
    • Standard HMO
  • Capital Blue Cross
    • Blue Journey HMO
    • Blue Journey PPO
  • Cigna-HealthSpring
    • Preferred HMO
    • Preferred Plus HMO
    • PreventiveCare HMO
    • Total Care HMO
    • Traditions HMO (I)
    • Achieve HMO ©
    • Advantage HMO
  • Coventry Advantra
    • Gold PPO
    • Silver HMO
    • One PPO
  • Humana
    • Choicecare Network HMO
    • Choicecare Network PPO
    • Choicecare Network PFFS
  • Independence Blue Cross
    • IBC HMO K65 Focus
    • IBC HMO Medicare
    • IBC PPO Medicare
  • Keystone 65
    • Basic Rx HMO
    • Focus Rx HMO
    • Preferred Rx HMO
    • Select Rx HMO
  • Personal Choice 65 Rx PPO
  • United Healthcare
    • Unitedhealthcare Dual Complete
    • Unitedhealthcare Group Medicare Advantage Plans
    • Unitedhealthcare Assisted Living Plan (PPO)
    • Unitedhealthcare Nursing Home Plan
  • UPMC for Life
    • HMO
    • PPO

    We do not participate in the following UPMC plans:

    • UPMC for Life HMO Premier Rx
    • UPMC for Life Plans Berks County

Plans without Drug Coverage

  • Cigna-HealthSpring Advantage HMO
  • Humana
    • Gold Choice PFFS
    • Choice (regional PPO)
  • Keystone 65
    • Preferred Medical Only HMO
    • Select Medical Only HMO
  • United Healthcare AARP Medicare Complete

Special Needs Plans

  • Cigna-HealthSpring
    • Achieve HMO (C)
    • Total Care HMO
    • Traditions HMO
  • Gateway Health Medicare Assured
    • Diamond HMO
    • Ruby HMO
  • Humana Gold Plus HMO
  • Keystone First VIP Choice HMO
  • United Healthcare
    • AARP Medicare Complete
    • UHC Dual complete
    • UHC Group Medicare Advantage Plans
    • UHC Assisted Living Plan (PPO)
    • UHC Nursing Home Plan
  • UPMC for Life Dual HMO

CHIP

  • Aetna Better Health Kids
  • Capital Cares for Kids
  • IBC CHIP
  • Keystone HMO CHIP
  • UHC CHIP
  • UPMC for Kids

Marketplace/ACA Plans

  • Capital Blue Cross
    • Bronze PPO 7350-0-60
    • Silver PPO 5000/10/30
    • Gold PPO 2000/10/20
  • Independence Blue Cross (Tier 1)
    • Keystone HMO Platinum
    • Keystone HMO Gold
    • Keystone HMO Gold Proactive (tiered network plan)
    • Keystone HMO Silver
    • Keystone HMO Silver Proactive (tiered network plan)
    • Keystone HMO Bronze
    • Personal Choice® PPO Platinum
    • Personal Choice PPO Gold
    • Personal Choice PPO Silver
    • Personal Choice PPO Silver Reserve
    • Personal Choice PPO Bronze
    • Personal Choice PPO Bronze Reserve
    • Personal Choice PPO Catastrophic
  • UPMC Health Plans
    • Tower UPMC Advantage Bronze
    • Tower UPMC Advantage Silver
    • Tower UPMC Advantage Gold

Understanding Your Financial Responsibility

When you are scheduled for a doctor’s appointment or other test, study or procedure at any of our Pottstown Hospital locations, the representative who checks you in will enter information needed for your patient chart, and to help us bill your insurance. At this time, we will:

  • Discuss your portion of the financial responsibility. We will let you know how much your co-pay and deductible will be for the service we will be providing.
  • Discuss any past-due balances you may have with Pottstown Hospital.
  • Discuss payment options for your co-pay, deductible and any past-due balances.

There are several payment options available to you at the time of registration. They include credit card using our secure card swipe at your point of service registration, or you can pay with a check, money order or cash.

If you cannot pay the patient responsibility portion of your bill, one of our patient financial service representatives will speak to you about options. This may include a partial payment at the time of service and arranging a payment plan.

Billing

We have answers to your questions.

What's the billing process?

We'll bill your insurance company in a timely manner and do everything we can to expedite your claim. But remember, payment is ultimately your responsibility. If we bill your insurer, and after 30 days the account is not taken care of, we'll look to you for final settlement of your bill.

You can pay your bill online here.

Otherwise, we accept:

  • Cash
  • Check
  • Money order
  • VISA
  • MasterCard
  • American Express
  • Discover

Questions?

Have your patient number and date of the hospital visit in question handy, and contact: 833-341-5488.