You’ll find a list of insurance and managed care plans below – these are most, though not all, of the plans with which we are currently contracted to provide care.  

While our privacy policy is provided to you at your visit, we include it here so that you may have a chance to review it in advance.

 

Policies

Office Hours and Visits

You may phone our office from 9:00 AM to 5:00 PM Monday through Friday to schedule an appointment.

When scheduling your appointment, please advise our staff on the extent of your needs so that we may schedule the appropriate amount of time. If your problem is urgent we will make every effort to accommodate you as quickly as possible.

Occasionally emergencies develop resulting in changes to our schedule. If your physician's schedule is affected, you will be given the option of rescheduling or seeing one of our other physicians. In order for us to make a complete assessment of your medical problem, please provide us with an accurate list of all medications (prescription and non-prescription), x-rays and diagnostic test results.

Telephone Calls

Except in emergencies, our doctors do not accept calls while they are seeing patients. Our staff is experienced and able to answer most questions or they will relay your message to your doctor. When necessary, they will obtain appropriate answers from your doctor immediately or give you an approximate time to expect a return call.

If you need to reach us in an emergency after office hours, call the office phone number. Our answering service will locate the physician on-call.

Prescription Refills

Prescriptions cannot be refilled after normal working hours or on weekends. You should keep close track of your medications and allow at least three business days for refills to be processed.

Financial Policies

As a courtesy to our patients, we submit claims to all insurance companies provided we have complete and accurate information. To ensure your claim is submitted in a timely fashion, please make sure the following insurance information has been included in your registration process. It is our commitment to assist you in getting your claim processed, however, it is your responsibility to make sure we have accurate information. Without this information you will be responsible for payment.

Required Billing Information:

  • A copy of your current insurance card

  • Effective date of your insurance

  • Complete name, address and telephone number of insurance company

  • Name and address of policyholder

  • Relationship to policyholder

  • Secondary insurance, if applicable

Co-Payment

Your insurance company requires you to pay your co-pay at time of service. Failure to do so is a violation of your contract with your insurance company. This concept was created by the insurance industry to lower your premium by requiring the patient to pay a co-pay at every visit. Physicians also agreed to lower the amount they would accept as payment in full from the insurance companies because they were promised they would save the cost of sending statements for co-pays. Please do not expect that we will “bill” you, since the cost of sending a statement is often times much more than your co-pay.

Deductible

This is an often overlooked or misunderstood issue. When we subscribe to insurance coverage, we agree to a "deductible" amount. The deductible amount is always the patient's responsibility. Until the deductible amount is satisfied, your insurance is not responsible for payment. We will, however, submit your claim to your insurance company so the amount for service will go towards satisfying your deductible.

Statements

Billing statements are mailed once a month unless there is insurance pending and in that case, you will not receive a statement until we have been reimbursed by your insurance company. If after 60 days we have not received payment from your insurance we will look to you, our patient, for assistance in getting your account paid.

Refunds

Any credit on an individual account will be applied to any balance due.
 

Insurance

Payment is requested at the time services are rendered. For your convenience we accept MasterCard, Visa, personal checks, money orders or cash.

We participate in a variety of HMO and PPO insurance plans. In accordance with the terms of your HMO/PPO plan, the patient co-payment is due at each visit.

Our Billing Department will be happy to assist you with any matter related to your account. The business hours for the Billing Department are Monday through Friday 9:00 AM to 5:00 PM. Their phone number is 925-560-9300.

Workers' Compensation carriers are billed and you will not receive a statement if your claim has been authorized and approved.

If you find that Tri-Valley Orthopedic Specialists, Inc. is not listed as a participating group, or if your TVO physician is not listed, we encourage you to contact our Chief Operating Officer, so that we can inquire of your insurance company about being added to the network of providers offered for your plan.

The list below contains most, although not all, of the names of the insurance carriers and managed care organizations with which TVO is contracted.  For some of these health benefit plans, we provide care through our affiliation with Affinity Medical Group and Bay Valley Medical Group.

Contracted Insurance, Managed Care and Workers’ Compensation Companies

  • Aetna US Healthcare

    • Elect Choice

    • Managed Choice

    • Open Choice PPO

  • Amera-Net, Travel Network

  • Affinity PPMSI

    • Pacificare Commercial HMO

    • Blue Cross Commercial HMO

    • Aetna US Healthcare Select Choice

    • Cigna Healthcare

    • HealthNet Commercial HMO

    • HealthNet Seniority Plus   

    • PacifiCare Secure Horizons

  • BAPP

    • Admar Corp.

    • Beech Street Network PPO, Auto, WC

    • Beech Street Fed Med/Aetna NAP

    • Choice Care Network PPO

    • Humana PPO

    • HMN PPO

    • Interplan Health Gr. PPO/WC

    • Multiplan PPO

    • Admar PPO

    • AHC PPO

    • BCE Emergis PPO

    • BPS Healthcare PPO

    • Formost PPO

    • Health Network PPO

    • MedNetwork PPO

    • Pro-America PPO

    • Up & Up PPO

    • Three Rivers Provider Network PPO/WC

    • MCS PPO

    • USA MCO PPO/WC

  • Bay Valley Med. Group

    • Aetna

    • Blue Cross

    • Blue Shield

    • HealthNet

    • Pacificare

    • Great West

  • Blue Cross Of CA

  • Blue Shield

  • CCN PPO Network

    • C N A thru CCN

    • Mutual Of Omaha thru CCN

  • Cigna Healthcare

    • HMO

    • PPO

  • Corvel

  • HealthNet PPO

  • First Health/Coventry Health Care

    • PHCS/Multi-Plan

  • Great West Healthcare PPO (Formerly One Health)

    • POS

    • Open Access

  • Great West HMO only under Bay Valley Med. Group

  • Interplan PPO  Individual

  • Medicare

  • Pacificare PPO

  • Pacific Foundation

    • EPO

    • PPO

  • Palo Alto Medical Foundation

    • HMO

    • PPO

  • PHCS

  • PPO Next (Preferred Health Network

  • Triwest/Tricare Healthcare Alliance

  • United Healthcare Trust

  • WORKERS' COMP NETWORK

    • Calif. First Health Comp HCO & MPN

    • Chevron/Texaco Provider Network

    • Dept. Of Labor, Olympia, Washington

    • Kaiser On The Job Network

    • Liberty Mutual MPN

    • Marriott's Medical Provider Network

    • Medical Partners@Work (Sutter Health)

    • Medex HCO Network

    • Nordstrom Medical Provider Network MPN

    • DEOIC Div. Energy Emp. Occ. Illness

    • OWCP/Dept. Of Labor

    • Preferred Health Network/PPO Next

    • Safeway Select Medical Provider Network

    • Sedgwick CMS Med. Provider Network (Kaiser Network)

    • State Fund Medical Provider Network

  • Hayward Unified School District Workers' Com

Privacy Policy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

We are required by law to provide you with this notice that explains our privacy practices with regard to your medical information and how we may use and disclose your protected health information for treatment, payment, and for health care operations, as well as for other purposes that are permitted or required by law. You have certain rights regarding the privacy of your protected health information and we also describe them in this notice.

Read our complete Privacy Policy