Insurance Payment Guide
This guide does not include or exclude Corporate clinics -Please refer to individual Corporate protocols.
For additional insurance information please visit:
Clinic Location: Massachusetts
Payment Plans:
Cash or Check
Accepted at: All Locations
Medicare Part B
Accepted at: All Locations
Insurance Cards:Medicare Part B (Medical) insurance card
Flu Shot Covered:Yes
Pneumonia Shot Covered:Yes
Verification:Medicare Part B (Medical) insurance card and picture ID
Special Notes:Maxim will not give second doses of PPSV except for those persons over 65 years of age who received the pneumonia shot prior to 65 and it has been 5 years or more since their last pneumonia shot. Individuals with part B primary complete the Medicare Consent form.
PFFS type Medicare Advantage Plans
Note there are many health plans that offer PFFS plans
Accepted at: All Locations
Insurance Cards:PFFS (“Private Fee For Service”) type Medicare Advantage cards
Flu Shot Covered:Yes
Pneumonia Shot Covered:Yes
Verification:Must say “PFFS” on Medicare Advantage card (example below)
Special Notes:If a participant has a PFFS card with a health plan NOT on our Insurance Payment Guide, complete the Medicare Consent form entering both the Advantage Plan info as well as the Medicare ID#. Advantage plan MUST include PFFS after plan name. No Medicare consent form should contain only Advantage plan ID #, it should always be accompanied with a traditional Medicare ID#. For Medicare Advantage plan members without a PFFS type plan, please refer to the payment process flow chart for instructions on how to properly process the individual.
Aetna
Accepted at:All Locations
Insurance Cards:All Aetna Cards: Every insurance plan Aetna offers is accepted.
Do not turn any Aetna member away.
Flu Shot Covered:Yes
Pneumonia Shot Covered:No – member must pay out of pocket and fill out the
Immunization Consent form.
Verification:Must see Insurance ID card to ensure it is an Aetna medical plan. Be sure that membership number and information is correct and clear on the consent form.
Special Notes:There are no special vouchers needed. Anyone with an Aetna ID card is eligible for a flu shot.
Anthem Blue Cross Blue Shield Plans (specific state plans listed below)
Anthem Plans:Anthem BCBS CA, Anthem BCBS CO, Anthem BCBS CT,
Anthem BCBS GA, Anthem BCBS IN, Anthem BCBS KY, Anthem BCBS ME, Anthem BCBS MO, Anthem BCBS NV, Anthem BCBS NH, Anthem BCBS OH, Anthem BCBS VA, Anthem BCBS WI
Accepted at:All states where Anthem/Blue Cross Blue Shield Plans are accepted
Insurance Cards:All cards and all members that have Anthem Blue Cross Blue
Shield.
NOTE:Anthem CA: HMO PLANS NOT ACCEPTED AND BLUE SHIELD CA PLANS NOTACCEPTED
NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse should check the Anthem BCBS insurance card and confirm the ID on the consent form matches the insurance card that has been presented at the time of service
Blue Cross Blue Shield of Illinois
Accepted at:All states where Anthem/Blue Cross Blue Shield Plans are accepted
Insurance Cards:All cards and all members that have Blue Cross Blue Shield
NOTE: ALL FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please confirm number on card against number on the consent
Blue Cross Blue Shield of Massachusetts
Accepted at:All locations where insurance plans are an option for payment
Insurance Cards:All cards and all members that have Blue Cross & Blue Shield of MA. NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse should ask for insurance card and ID to confirm member. They can also confirm that is it a Blue Cross & Blue Shield of MA member, by turning the card to the back side and on the lower right corner it will identify that if it is a Blue Cross of MA plan. Must include ID #, Group # and member identifier on the consent form.
Blue Cross Blue Shield of North Carolina
Accepted at:All states where Anthem/Blue Cross Blue Shield Plans are accepted
Insurance Cards:All BCBSNC commercial plans, State Health Plan, Federal Employee Health Plan, Partners
NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse should ask for insurance card and ID to confirm member. Must include member ID#, Group #, and member identifier (2 digit #) on BCBSNC specific consent form
Blue Cross & Blue Shield of Rhode Island (RI)
Accepted at:All states where Anthem/Blue Cross Blue Shield Plans are accepted
Insurance Cards:All cards and all members that have the Blue Cross & Blue Shield of RI and the clinic has been identified as an event we are accepting insurances as an option
NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check the Blue Cross & Blue Shield of RI insurance card and confirm ID on the consent form matches the insurance card that has been presented at the time of service
Blue Cross & Blue Shield of Texas (TX)
Accepted at:All states where Anthem/Blue Cross Blue Shield Plans are accepted
Insurance Cards:All cards and all members that have the Blue Cross & Blue Shield of TX and the clinic has been identified as an event we are accepting insurances as an option
NOTE: ONLY PPO PLANS ACCEPTED
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check the insurance card for PPO plan (only accepted) and ID matches the consent form.
Premera Blue Cross
Accepted at:Retail and Corporate
Insurance Cards:Premera Blue Cross Plans Only
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:The Nurse must match picture identification with the Premera Blue Cross insurance identification.
Special Notes:We are only accepting Premera Blue Cross plans. The card must say Premera Blue Cross on it in order to be accepted
Regence BC/BS of Oregon
Accepted at:All Locations
Insurance Cards:All Regence BC/BS of Oregon plans with the exception of the FEDERAL EMPLOYEE PLAN. NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED AT ANY CLINIC. All FEP members can be identified as any ID number with the format R#########. It is an R prefix followed by eight digits. All cards must say Regence BC/BS of Oregon. No other blues plans are accepted.
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check card and confirm ID on consent form matches the insurance card. Card must state that it is Regence BC/BS of Oregon Plan. DO NOT ACCEPT FEDERAL EMPLOYEE PLAN (FEP) or ID’s that have a prefix of R########.
Regence BlueShield of Washington/ Uniform Medical Plan
Accepted at:All Locations
Insurance Cards:All Regence BlueShield of WA and Uniform Medicalplans are accepted.All eligible cards must state Regence or UMP (Uniform Medical Plan)on the card in order to be accepted.
NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse must check member’s insurance card and ID
Regence BC/BS of Idaho
Accepted at:All Locations
Insurance Cards:All Regence BlueShield of Idaho are accepted.All eligible cards must state Regence on the card in order to be accepted.
NOTE: FEDERAL (FEP) PLANS ARE NOT ACCEPTED OUT OF STATE
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse must check member’s insurance card and ID
Florida Blue
Accepted at:All locations
Insurance Cards:Florida Blue (BCBSFL) Member ID cards- Worksite- Employer Groups
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Nurse must match Florida Blue (BCBSFL) employee member ID card with photo ID. Nurse to collect all demographic and
insurance ID information on Maxim insurance consent form
Connecticare
Accepted at:All Locations
Insurance Cards:All Cards, All Plans
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please confirm number on card against number on the consent form.
Fallon Community Health
Accepted at:All locations where insurance plans are an option for payment
Insurance Cards:All cards and all members that have Fallon Community Health and the clinic has been identified as an event we are accepting insurances as an plan.
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check Fallon Community Health insurance card and confirm ID on consent form matches the insurance card that has been presented at the time of service.
Harvard Pilgrim
Accepted at:All locations where insurance plans are an option for payment
Insurance Cards:All cards and all members that have Harvard Pilgrim and the clinic has been identified as an event we are accepting insurances as a option
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check Harvard Pilgrim insurance card and confirm ID on consent form matches the insurance card that has been presented at the time of service
Healthspring
Accepted at:All Clinics
Insurance Cards:All Healthspring members
Flu Shot Covered:Yes
Pneumonia Shot Covered:Yes
Verification:Complete all participant demographic information. List Insurance name as Healthspring, also requires member ID# and Group #
Humana
Accepted at:All Locations
Insurance Cards:All Humana cards/plans except POP plans.
Flu Shot Covered:Yes
Pneumonia Shot Covered:Yes
Verification:Nurse to confirm that recipient has acceptable plan. Check driver’s license and complete consent form including: name, address, date of birth, policy number, group number. All fields of consent are required
Independence Blue Cross Blue Shield
Accepted at: All Locations
Insurance Cards: Keystone Health Plan East Personal Choice PPO Independence Blue Cross
Flu Shot Covered: Yes
Pneumonia Shot Covered: No
Verification: Nurse must check member’s insurance card and ID
Sierra Health & Life
Accepted at: All Locations
Insurance Cards: Sierra Health & Life
Flu Shot Covered: Yes
Pneumonia Shot Covered: NO
Verification:Nurse must check member’s insurance card and ID
SummaCare
Accepted at:All public access clinics and any corporate clinic that has SummaCare coverage
Insurance Cards:All SummaCare Plans
Flu Shot Covered:Yes
Pneumonia Shot Covered:Yes
Verification:Nurse must check member’s insurance card and ID
Tufts Health Plan
Accepted at:All locations where insurance plans are an option for payment
Insurance Cards:All cards and all members that have Tufts Health Plan insurance and the clinic has been identified as an event we are accepting insurances as an option
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check the Tufts Health Plan insurance card and confirm ID on the consent form matches the insurance card that has been presented at the time of service
UniCare State Indemnity Plan
Accepted at:All locations where insurance plans are an option for payment
Insurance Cards:All cards and all members that have UniCare State Indemnity Plan and the clinic has been identified as an event we are accepting insurances as an plan.
Flu Shot Covered:Yes
Pneumonia Shot Covered:No
Verification:Please check the UniCare insurance card and confirm ID on consent form matches the insurance card that has been presented at the time of service.
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