General & Insurance Information

Appointment 

Please call 484-350-5141 to make your appointment.  Non-urgent messages can be left on answering machine and will be returned within 24 hours.  For medical emergencies, please dial 911.  Urgent phone call should be made to your primary care physician.

Office policy

Appointment

As a courtesy to our patients, we will attempt to confirm appointments at least the day before. However, it is your responsibility to keep the appointment even if we have not been able to confirm your appointment. Please allow at least 40-60 minutes for new patient visit and 30-45 minutes for follow-up appointments. Although we strive to keep our patients waiting time to a minimal, we may occasionally need to spend additional time with a patient to complete his/her treatment. Your understanding and patience is greatly appreciated.

Late Arrivals

TransValley Family Health makes every effort to keep to its appointment schedule. If you are more than 15 minutes late for your appointment, it may affect your treatment time or we may have to reschedule your appointment. 

Cancellation 

If you cannot keep your appointment, kindly notify us as soon as possible, so another patient needing medical attention can be seen. We require at least 24 hour notice (or before 8 am on Friday for Monday appointment). Failure to cancel or reschedule within this time frame may result in a $50 “no-show” fee.  However, the fee is waived if the appointment is filled by another patient. Please call as soon as possible if you cannot keep your appointment time.  We appreciate your effort.  

Silence 

Please turn your cell phone or electronic devices on vibrate before entering the treatment room.  

Primary care physician 

Please be advised that although Dr. Nguyen is also a board certified family physician, visits through this office will be limited to consultation for a specific medical problems with provided services include counseling, herbal remedies, homeopathic medicine, osteopathic manipulation, and acupuncture. All patients should have their regular primary care physicians for their overall general medical management and preventive services. 

Payment & Insurance Coverage

In order to provide excellent care free of potential influence from third party payers (i.e. health insurance companies), TransValley Family Health, PLLC does not participate with insurance companies.  This helps us lower operating expenses and keep costs reasonable to patients.  Therefore, our services will be considered to be “out-of-network” for all insurance. A medical bill can be provided to you to submit to your insurance for reimbursement (Medicare patients – see below).    

Not all insurance plans cover OMT and acupuncture.  Please call your medical insurance company prior to making your appointment to check if your policy covers “out-of-network” services given by Dr. Nguyen.  Your medical bill usually has an E&M and diagnostic codes.  A “modifier-25” is included if a procedure is deemed appropriate & given during the visit, along with the procedure code.  When you contact your insurance, please give the codes in the following numbers 1 to 3: 

1.  Evaluation & management (E&M) code – based on the evaluation and treatment plan from your office visit, with different levels of complexity (indicated by the last digit).  This is a doctor office visit fee, and it is often covered by insurance under out-of-network policy.  For example:  For a new visit:  99202, 99203, 99204, or 99205B.  For an established visit: 99212, 99213, 99214, or 99215 ​

2.Modifier-25 (an insurance term that allows a procedure to be paid on the same day of your visit) 

3. Procedure code(s) – acupuncture and/or OMT code(s).  There are 5 OMT procedure codes, which code will be used after a treatment will depend on the number of body regions that are treated.  Generally, if your insurance covers one of them, it covers the others as well.

  • 98925 (OMT 1-2 body regions)
  • 98926 (OMT 3-4 body regions)
  • 98927 (OMT 5-6 body regions)
  • 98028 (OMT 7-8 body regions)
  • 98929 (OMT 9-10 body regions) 

There are 4 acupuncture procedure codes.  Dr. Nguyen often uses electrical stimulation, and the average time spent is about 30 minutes; more or less depending on complexity of the treatment (a typical acupuncture treatment is usually 97813 + 97814).

  • 97813 Acupuncture with electrical stimulation, initial 15 minutes
  • 97814 Acupuncture with electrical stimulation, additional 15 minutes
  • 97810 Acupuncture without electrical stimulation, initial 15 minutes
  • 97811 Acupuncture without electrical stimulation, additional 15 minutes

 4.  Diagnostic code(s) – for the problem(s) addressed on the visit 

Example of a bill for a new OMT visit:  

  • 99204
  • Modifier-25
  • 98929
  • ICD-10 diagnostic codes: M54.4 (low back pain), M99.03 (somatic dysfunction of lumbar spine), etc.

Example of a bill for a new acupuncture visit:  

  • 99204
  • Modifier-25
  • 97813 + 97814
  • ICD-10 diagnostic codes: M54.4 (low back pain)

For Medicare insurance (primary),TransValley Family Health, PLLC will submit your claim on your behalf to Medicare.  Currently as of May 2021, Medicare reimburses some of the acupuncture treatments for certain low back pain conditions, and most of the cost for osteopathic treatments. Your supplemental insurance often reimburses what’s left covered by medicare. TransValley Family Health, PLLC is not responsible for how much (if any) will be reimbursed to you by your insurance(s).  Please check with your insurance regarding coverage before receiving services.

If you have a Medicare Advantage plan (examples: Aetna, Anthem, UnitedHealthcare, Humana, Cigna, Kaiser), you will need to submit the claim directly to your primary insurance yourself.

If you have any questions, please call the office.