Billing & Insurance

Reading Hospital is committed to providing affordable, quality healthcare to all patients. We understand that billing and payment for healthcare services can be confusing.

Knowing your insurance policy is important for you to receive the maximum benefits for your healthcare services. Your benefit coverage level for care provided by Reading Hospital is determined solely by your insurance. Reading Hospital is contracted with many health plans. A list of those plans can be found below. You can also call our Patient Financial Services office at 484-628-5683 for a complete list.

Our list is not meant to be all-inclusive and is subject to change. Please check with your health plan to verify coverage.

Special Note:

Insurance Information

Reading Hospital has contracts with the following health insurance companies:

Commercial (Insurance through your employer)

  • Aetna
    • Aetna HMO
    • Aetna HMO (Open Access)
    • Aetna HMO / Health Network Only
    • Aetna PEBTF PPO
    • 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
  • AmeriHealth Administrators
  • Capital Blue Cross
    • CareConnect – PinnacleHealth ACA Network
    • Comprehensive
    • POS
    • PPO
    • Traditional
    • HMO

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

    • PPO Choice
    • Valley Advantage EPO
  • Cigna
    • ChoiceFund OA Plus
    • Open Access Plus
    • OA Plus
    • ChoiceFund OA Plus with CareLink PPO
    • Choice Fund PPO Network
    • HMO
    • POS
  • Coventry
  • EHP Significa Network
  • First Health Network
  • Great West
  • HealthAmerica/Health Assurance
  • Highmark Blue Shield (NOTE: standard tier)

We do not participate in the following Highmark plans:

    • Community Blue Medicare HMO
    • My Direct Blue EPO
  • Independence Blue Cross
    • Keystone HMO Proactive (Tier 3)
    • Keystone HMO/POS/Direct POS
    • Personal Choice PPO
    • Personal Choice EPO
    • Personal Choice Tiered (Tier 2)
    • National BlueCard PPO
    • IBC HMO Commercial tier 3 Standard
    • IBC PPO Commercial
    • AmeriHealth PPO & HMO Commercial
    • AmeriHealth Comprehensive Major Medical
  • Keystone Health Plan Central
  • Keystone Health Plan East
  • Tower Health PPO
  • TriCare
  • United Healthcare
    • Unitedhealthcare Navigate
    • 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 Student Resources
    • UHC Compass Rose PPO Plan

    We do not participate in the following United Healthcare plans:

    • 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 Employees Out of Area PPO Plan
      • UPMC Out of Area Gold
      • UPMC Out of Area Silver
    • UPMC Total Advantage PPO
    • 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)
    • Partner Network Plans (HMO and EPO Plans)
    • UPMC Business Advantage HMO (Referral Required)
    • UPMC Business Advantage HMO (No Referral)
    • Enhanced Access (HMO and POS Plans)
    • UPMC Employees Advantage (EPO Plans)
    • Panther Gold Advantage HMO (For Pitt Employees)
    • Panther Gold HMO (For Pitt Employees)
    • FEHB Plans
    • UPMC Inside Advantage Level 1 Providers
    • MyCare Advantage HMO Level 1 Providers
    • MyCare Advantage HMO Level 2 Providers
    • MyCare Advantage PPO Level 1 Providers
  • VA CCN (VA Community Care Network) administered by Optum/United Healthcare

CHIP (Children's Health Insurance Program through the state)

  • Aetna Better Health Kids
  • Capital Cares for Kids
  • Highmark CHIP
  • UPMC for Kids

Marketplace/ACA Plans (Independent insurance plans through the Affordable Care Act)

  • Capital Blue Cross
    • Bronze PPO 7350-0-60
    • Silver PPO 5000/10/30
    • Gold PPO 2000/10/20
  • Independence Blue Cross (Tier 3)
    • 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

Medicaid HMO (Insurance program through the state for those requiring financial assistance)

  • Aetna Better Health
  • AmeriHealth Caritas
    • Pennsylvania
    • Northeast
    • Community Health Choices
  • Gateway Health Plan
  • Keystone First (except Tower Health Medical Group/hospital-based clinics, which are out of network)
  • UHC Medicaid
  • UPMC for You
    • Health Choices
    • Community Health Choices

Medicare Advantage (Insurance for people over 65 years of age or with disabilities)

Plans Offering Drug Coverage

  • AARP Medicare
    • Complete HMO
    • Complete Choice PPO
  • Aetna Coventry
    • Advantra Gold PPO (1/1/20 new name - Aetna Medicare Advantra Premier Plus PPO)
    • Advantra Northern Pennsylvania Gold HMO (1/1/20 new name - Aetna Medicare Advantra Gold HMO)
    • Advantra Southeast Prime HMO (1/1/20 new name - Aetna Medicare Advantra Value HMO)
    • Advantra Silver HMO & PPO (1/1/20 new name - Aetna Medicare Advantra Silver HMO & PPO)
    • Advantra Silver Plus HMO & PPO (1/1/20 new name - Aetna Medicare Advanta Silver Plus HMO & PPO)
    • Advantra One PPO (1/1/20 new name - Aetna Medicare Advantra Credit Value PPO)
    • Advantra Basic Medical HMO (1/1/20 new name - Aetna Medicare Advantra Core HMO)
  • Aetna Medicare
    • Aetna PEBTF PPO
    • Choice HMO
    • Silver HMO & PPO
    • Gold PPO
    • Premier HMO
    • Standard HMO
    • Basic HMO

We do not participate in the following Aetna plans:

    • Not PEBTF HMO
  • AmeriHealth Caritas VIP Care
  • Capital Blue Cross Medicare Advantage
    • Blue Journey HMO plans (ALL)
    • Blue Journey PPO plans (ALL)
    • Blue Journey Essential
    • Blue Journey Value
  • Coventry Advantra
    • Gold PPO
    • Silver HMO
    • One PPO
  • Humana (Choicecare Network)
    • Humana Gold Plus HMO
    • Humana Choice PPO
    • Humana Gold Choice PFFS
  • Humana Gold Plus (HMO D-SNP)
  • Highmark Medicare Advantage
    • Freedom Blue PPO
    • Community Blue Medicare PPO (including Signature Plan)
    • Community Blue Medicare PPO Plus – Clinton, Lycoming, Sullivan, and Tioga Counties only

    We do not participate in the following Highmark plans:

      • Community Blue Medicare HMO (Signature Plan)
    • Independence Blue Cross
      • IBC HMO Medicare Basic/Select
      • IBC HMO Medicare
      • IBC PPO Medicare
      • Amerihealth HMO Medicare
    • Keystone 65
      • Basic Rx HMO
      • Preferred Rx HMO
      • Select Rx HMO

    We do not participate in the following Keystone 65 plans:

      • Focus
    • Personal Choice 65 Rx PPO
    • Tricare for Life
    • United Healthcare
      • Unitedhealthcare Dual Complete
      • Unitedhealthcare Group Medicare Advantage Plan
      • Unitedhealthcare Assisted Living Plan (PPO)
      • Unitedhealthcare Nursing Home Plan
    • UPMC for Life
      • HMO
      • PPO

    Plans without Drug Coverage

    • Keystone 65
      • Preferred Medical Only HMO
      • Select Medical Only HMO

    We do not participate in the following Keystone 65 plans:

      • Focus
    • United Healthcare AARP Medicare Complete

    Special Needs Plan

    • Aetna Coventry
      • Advantra Cares (HMO SNP) -(1/1/20 new name - Aetna Medicare Advantra Cares HMO D-SNP)
    • Gateway Health Medicare Assured
      • Diamond HMO
      • Ruby 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

    Behavior Health Organization (Administrator/Payor of behavioral health benefits)

    Payor Product Lines
    Cigna Behavioral Health Commercial, Medicare
    Community Care Behavioral Health (CCBH) Commercial, Medicare, Medicaid
    Magellan Commercial
    MH Net Commercial, Medicare
    Optum Commercial
    Quest Commercial

    Please call Customer Service (at the number on the back of your insurance card) to determine your Behavioral Health insurance vendor.

    We also accept Medicare and Medical Assistance.

    Reading Hospital will gladly submit a bill to any insurance carrier on your behalf. However, that is not a guarantee that the insurance carrier will pay the claim.

    It is important for you to be aware of your benefits and any restrictions that may apply to your specific plan. By being informed about what your health plan covers, you can be assured of receiving the maximum coverage to which you are entitled.

    Understanding Your Financial Responsibility

    When you are scheduled for a doctor’s appointment or other test, study or procedure at any of our Reading 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 Reading 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.

    Payment and Contacts

    • Pay Online
    • Phone: Dial 484-628-5820 or toll-free 866-333-5820 between the hours of 8 a.m. and 5 p.m.
    • Via E-Mail
    • In Person: Visit the Patient Billing Services office located in C-Building on the second floor between the hours of 8 a.m. and 4:30 p.m. (Enter at the 6th Avenue Lobby)
    • Receive a price quote for services.

    Billing and Payment: Reading Hospital

    Billing and Payment: Reading Hospital Surgical Services

    Our Collection Policy

    Download our collection policy [PDF].