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AETNA - HMO Plans
*Cannot be seen at Heritage or The Breast Center |
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Pre-Certification
requirement through Medsolutions for CT, MRI, MRA, PET
Scan, and HSG for infertility |
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1-888-693-3211 |
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AETNA - Managed Care MCII/PPO or MC/PPO |
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Check
for Pre-Certification requirement |
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1-888-693-3211
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| AMERIGROUP (Americaid) |
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Pre-Auth through MedSolutions - MRI, MRA, CT, PET, and MUGA Scans |
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See patient's card
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ANTHEM - PPO/POS BC/BS
of Virginia
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Call for Pre-Authorization
for MRI, MRA, DEXA, HSG, Invasive Study and Brain
SPECT, Nuclear Medicine Exam |
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1-800-242-7277 |
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ANTHEM - Healthkeepers
*Only 2 routine OB sonograms are covered |
|
Call
for Pre-Authorization for MRI, MRA, DEXA, HSG, Invasive
Study and Brain SPECT, Nuclear Medicine Exam |
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1-800-533-1126 |
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CAREFIRST- BC/BS
of Maryland |
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Signed prescription needed from referring doctor |
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CIGNA - HMO / PPO / POS Plans and OPEN ACCESS |
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For MRI, MRA & CT, and
PET Call Med- Solutions for Pre-Authorization |
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1-888-693-3211 |
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COMMERCIAL
PLANS (ALL) |
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Signed prescription needed from referring doctor |
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Department of Labor
(MED SOLUTIONS) |
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Need Pre-Auth for all exams. Will need Diagnosis code, CPT code and claim number |
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1-866-335-8319 |
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| FIRST HEALTH |
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Signed prescription needed from referring doctor |
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Verify Pre-Auth on requirement on card |
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KAISER
(MEDICAL IMAGING
NETWORK) |
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Must have referral for
MRI, MRA, Nuclear Medicine, Positron Emission Tomography, and interventional studies. Referrals for Mammograms for under 39 yrs and over 70 yrs of age. |
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1-800-810-4766 |
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MAMSI LIFE & HEALTH |
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Signed prescription needed from referring doctor Pre-Auth required for HSG W/ infertility diagnosis |
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MDIPA / OPTIMUM CHOICE
HMO |
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Referral for MRI, MRA, CT's, DEXA, Nuclear Medicine, certain procedures may require preauthorization. Preauthorization needed for HSG with diagnosis of infertility. Verify requirements with your insurance company |
|
Verify Co-pay on
card
1-800-738-1837 |
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MEDICARE - TRAILBLAZER
PART-B SERVICES ONLY |
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Signed prescription needed from referring doctor |
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NALC |
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No Authorization Needed |
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NCPPO |
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Signed prescription needed from referring doctor |
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One Net
Formally ALLIANCE - PPO |
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Signed prescription needed from referring doctor |
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One Net
Formally ALLIANCE - APWU |
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Call Med Solutions for Pre-Auth for MRI, CT, PET |
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1-888-693-3211
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One Net
Formally ALLIANCE - GEHA |
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Call Med Solutions for Pre-Auth for MRI, CT, PET Scan |
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1-866-879-8317 |
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OPTIMUM CHOICE PREFERRED |
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Referral for MRI, MRA & Biopsy. Pre-Auth needed for HSG w/ infertility diagnosis. Pre-Auth needed for certain MRI and CT studies. Need waiver signed to use Out-of-Plan benefit. |
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PHCS |
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Signed prescription needed from referring doctor – Pre-Auth for MRI, MRA, PET, CT |
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TRICARE Standard
/ HEALTH NET (Formerly
"CHAMPUS") |
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Signed script needed from referring doctor. Pre-Operative Chest Xray and Routine Obstetric Sonograms are not covered |
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TRICARE
FOR LIFE / HEALTH NET (also called
TRICARE Prime) |
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Signed script needed from referring doctor. Pre-Operative Chest Xray and Routine Obstetric Sonograms are not covered |
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UNITED HEALTHCARE
- MID-ATLANTIC / PPP / POS |
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Pre-notification needed for certain groups for MRI/MRA, CT PET and Nuclear Medicine |
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1-866-889-8054
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WORKERS COMPENSATION
PLANS |
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Call
for Pre-Certification on all exams; need authorization
# |
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Need Employer
and Policy Information |
