| Company |
Requirements |
| ACCORIDA (SHAW) |
Requires Rx only. |
| ACCESS HEALTHCARE (Medicaid) |
WE DO NOT ACCEPT |
| ADVANTAGE FREEDOM (Medicare) |
Requires Rx only. |
| AMERICA HEALTH CHOICE |
Requires pre-cert for MRI’S, CTs,PET’s, Nuc Med’s, and Angio’s. |
| AMERICHOICE PLUS |
We accept/its United Health Care Medicaid. Rx Only. |
| APWU |
Requires pre-cert for MRI’S, CTs,PET’s, Nuc Med’s. |
| ALL AETNA |
Requires pre-cert for CT Scans, MRA’s, MRI’s and PET Scans.
As of March 1, 2007 all AETNA PPO’s will need authorizations for CT’s, MRI’s, MRA’s, CTA’s, PET SCAN’s, Nuclear Med Studies. |
| AHA SOUTHCARE |
Requires pre-cert for CT Scans, MRI’s, MRA’s, PET Scans, and Nuc Med studies. |
| AMERIGROUP (Healthy Kids) |
Requires authorization for CT Scans and MRI’s. |
| AMERIBEN |
Requires Rx only. |
| ASSURANT HEALTH |
Requires Rx only. |
| ASSURE CARE |
Requires authorization for MRI’s. |
| AVMA |
Requires Rx only. |
| AV-MED |
Requires authorization for CT Scans and Angio’s, MRA’S, MRI’s, and PETScans. |
| BAYCARE (Medicaid) |
WE DO NOT ACCEPT |
| SOME BCBS |
Requires authorization for CT’s, Angio’s, MRI’s, MRA’s, PET SCAN’s, Nuclear Med. Allow 48 - 72hrs for pre-certification. (Depends on the alpha prefix.)
|
| BEECHSTREET |
Beechstreet is the network, so please askwhat insurance company it is and list in the notes field. |
| BOON – CHAPMAN |
Requires authorization for CT Scans andMRI’s. |
| CAREPLUS MEDICARE |
Requires authorization for CT’s, CTA’s, MRI’s, MRA’s, PET Scans, and Nuclear Med.
|
| CARPENTER CONTRACTORS |
Requires Rx only. |
| CBSA |
Requires authorization for MRI and CT Scans. Requires RX only for all other studies. |
| CELTIC |
Requires Rx only. |
| CHAMPVA |
Requires Rx only. |
| CMS |
Requires Rx only and needs to be called to confirm there coverage @ (863)701-1551.
|
| CNIC HEALTH |
Requires Rx only. |
| CUSTOM BENEFIT ADMIN. |
Requires Rx only. |
| DEFINITY HEALTH |
Requires authorization for MRI’s,MRA’s, CT Scans. |
| (CHAMPUS) TRICARE PRIME |
Requires authorization for MRI’s,MRA’s and PET Scans. |
| TRICARE STANDARD |
Requires Rx only. |
| TRICARE – Mediplus (Medicare) |
Requires Rx only. |
| ALL CIGNA’S |
Requires authorization for CT Scans, MRA’s, MRI’s and PET Scans. All other studies requires Rx Only. (PLEASE REMEMBER DO NOT BOOK THIS MODALITY IN OPEN UPRIGHT MRI FOR ALL CIGNA’S)
|
| CITRUS (COMM) |
Requires authorization for CT Scan’s, CTA’s, MRI’s, MRA’s and NucMed. |
| CITRUS MEDICAID |
Requires authorization for MRI’s, MRA’s and NucMed. (If pt is on for prenatal care... only the first OB sono is covered... all subsequent sono’s, including Biophysical Profiles, requireauth!) |
| CITRUS MEDICARE |
Requires authorization for MRI’s, MRA’s and NucMed. |
| COMMUNITY HEALTH CARE |
Requires authorization for all studies. (PLEASE DO NOT BOOK ANY MRI’S IN PLANT CITY NOT COVERED BY COMMUNITY HEALTH CARE) (AS OF AUGUST 12, 2008 COMMUNITY HEALTH IS ENDING BUT BE SURE TO CHECK THERE EXPIRATION DATE ON THERE CARDS AND AUTH FORMS.) |
| EASTERN BENEFITS SYSTEMS |
Requires Rx only. |
| EBMS |
Requires Rx only. |
| EVERCARE CHOICE (Medicare) |
Requires Rx only. |
| EMPIRE PLAN PPO |
Requires Rx only. |
| FCE |
Requires Rx only. |
| FIRST HEALTH |
Requires authorization for CT Scans, MRI’s, and PETScans. |
FISERV
(Benefit Planners) |
Requires CT’s, CTA’s, MRI’sMRA’s, and PET Scans. |
| FLORIDANETPASS |
Requires authorization for all studies. |
| FLORIDA MILLWRIGHTS |
Requires Rx only. |
| FL UBC HEALTH FUND |
Requires Rx only. |
| FORTIS |
Requires Rx only. |
| FREEDOM (Medicare) |
Rx Only. |
| FREEDOM BLUE |
Rx Only. |
| FREEDOM HEALTH PLAN |
Requires precert for CT Scans, CTA’s, MRI’s, MRA’s, PET Scans, and Nuclear Med.
|
| GHI |
Requires pre-cert for CT Scans,MRA, MRI and PET Scans. |
| GEHA |
Requires pre-cert for CT Scans,MRA, MRI and PET Scans. |
| GENERAL AMERICAN |
No authorization required. |
| GOLDEN RULE |
Rx only. |
| GREAT WEST |
Requires authorization for CT Scans, MRA, MRI and PET Scans, U/S Guided Biopsies throughMed-Solutions. |
GREAT WEST
LIFE AND ANNUITY |
Requires authorization for all studies CT Scans, MRA, MRI and PET Scans, U/S Guided Biopsies through Med-Solutions.
|
| GOOD SAMARITAN |
Requires Rx only. |
| HARRINGTON BENEFITS |
Requires Rx only. |
| HARVARD PILGRIM |
Requires authorization for CT Scan’s,CTA’s, MRI’s , MRA’s, PET Scans |
| HEALTHSMART |
Requires Rx only. |
| HEALTHEASE |
Requires Rx only. |
| HEALTHEASE (healthy kids) |
WE DO NOT ACCEPT |
| HEALTH ASSURANCE |
Requires authorization for CT Scan’s,MRA’s, MRI’s, PET Scan’s. |
| HERITAGE (HCI) |
Requires Rx only for mammograms (screening or diagnostic) and U/S’s.
Requires pre-certfor CT Scans, MRI’s, MRA’s, and PET Scans. |
| HUMANA HMO |
Requires authorization for all studies except screening mammograms and plain x-rays. |
| HUMANA MEDICARE |
Requires authorization for CT Scans, MRI’s,and PET Scans. |
| HUMANA PPO |
Requires authorization CT Scans, MRI’S, Angio’s , PET Scan’s. |
| IMG |
Requires pre-cert for CT Scans, and MRI’s. Everythingelse requires Rx only. |
| INSURANCECENTER |
Requires Rx only. |
| INSURERS ADMIN. |
Requires pre-cert for CT Scans, MRI’s, MRA’s, Nuclear Med’s, CTA’s, PET Scans. |
| J.P. FARLEY |
Requires pre-cert for CT Scans, MRI’s, MRA’s, Nuclear Med’s, CTA’s, PET Ssans. |
| LUMENOUS |
Requires Rx only. |
| MAGNACARE |
Requires pre-cert for CT Scan’sand MRI’s. |
| MAIL HANDLERS |
Requires RX only. |
| MBS |
Requires Rx only. |
| MEDICAL MUTUAL OF OMAHA |
Requires Rx only. |
| MEDIPASS |
Requires authorization for all studies. |
| MEGALIFE |
Requires Rx only. |
| MERITAIN HEALTH |
Requires Rx only. |
| METCARE HEALTH (Advantage Care/Medicare) |
Requires authorization for CT Scan’s, CTA’s , MRI’s, MRA’s, PET Scan’s, Nuclear Med. TAKES 10 – 14 DAYS TO OBTAIN AUTH.
|
|
MIDWEST NATIONAL LIFE
|
Requires Rx only. |
| NATIONAL HEALTH SERVICES |
Requires Rx only. |
| NORTH AMERICAN ADMINISTRATORS L.P. |
Requires authorization for MRI’s,CT Scans, PET Scans. |
| ONE HEALTH HMO |
Requires authorization for everythingexcept screening mammograms. |
| ONE HEALTH PPO |
Requires RX only. |
| OXFORD |
Requires Rx only. |
| PARTNERCARE (Medicare) |
Requires precert for CT’s,CTA’s, MRI’s’, MRA’s, PET Scans Nuclear Meds.
|
| PENN WESTERN |
Requires Rx only. |
| PHCS |
Requires pre-cert for CT scans, MRI’s,MRA’s, and PET scans. |
| PHYTRUST |
Requires authorization for all studies. |
| PHYSICIANS UNITED PLAN (Medicare) |
Requires authorization for MRI’s, MRA’s,CT’s, CTA’s, PET Scans. TAKES 10 – 14 DAYS TO OBTAIN AUTH.
|
| PRAIRIE STATES |
Requires RX only. |
| PRINCIPAL |
Requires authorization for MRI’s, MRA’s, CTA’s, PET Scans. |
| PREFERRED BENEFIT ADMINISTRATIVE |
Requires Rx only. |
| PYRAMID (Medicare) |
Requires Rx only. |
| QHP |
Requires authorization CT Scans, MRI’s PET Scans, NUCLEAR MED’s, and angiograms.
This replaces Medicare, you must delete Medicare information when adding this!
PLEASE ALLOW 7-10 DAYS FOR AUTH COMPLETION! |
| SAMBA |
Requires Precert for MRI’s, MRA’s, PETS.
|
| SAGAMORE HEALTH |
Requires authorization for CT’s, CTA’s, MRI’s, MRA’s, PET’s, Stereotactic Bx’s. |
| SECURE HORIZONS (Medicare) |
Requires Rx Only except PET Scan’s. |
| SOUTHCARE/ SMITHFIELD FOODS |
Requires authorization for CT Scans, MRA’s,MRI’s and PET Scans. |
| SMITH ADMINSTRATORS |
Requires auth for CT’s, CTA’s, MRI’s, MRA’s and PET Scans. |
| STAR HRG |
Requires Rx only. |
| STAY WELL |
Requires authorization for MRA’s. |
|
STAYWELL (Healthy kids)
|
WE DO NOT ACCEPT |
| STRATEGIC RESOURCE CENTER (SRC) |
Requires Rx only. |
| TOWER LIFE |
Requires Rx only. |
| TALL TREE ADMIN |
Requires authorization CT Scan’s,MRI’S, PET Scan’s. |
| UABT |
Requires Rx only. |
| UCT |
Requires Rx only. |
| UNITED AMERICAN (Medicare Supplement) |
Requires Rx only. |
| UNICARE |
Requires authorization for CT Sscans and MRI’s. |
| UNITED HEALTHCARE |
Requires authorization for CT’s, MRI’s, Nuclear Med, PET Scan’s, Angio’s.(ONLY IF THE PCP DOES NOT MEET THE UHC NOTIFICATION)
|
| UNITED HEATH CARE (EMPIRE) |
Requires authorization for MRI’s,MRA, PET Scans. |
|
UNITED HEALTHCARE(Medicare)
|
Rx Only. |
| UNITED HEATH CARE (Medicaid) |
Requires authorization for MRI’s, CT’s, Angio’s, PET Scan’s,Nuclear Med.
|
| UNITED MEDICAL RESOURCE |
Requires Rx only. |
| UNIVERSAL |
Requires authorizations for CTA’s, MRI’s, MRA’s PET Scans. |
| UNIVERSAL (Medicaid) |
Requires Rx only. |
| UPMC |
Requires Rx only. |
| UTICA |
Requires Rx only. |
| WATKINS |
Requires RX only. |
| WAUSAU |
Requires RX only. |
| WELLCARE |
Requires authorization for PET Scans. |
| WELLCARE/MC (REPLACEMENT) |
Requires authorization for MRI’s, MRA’s,CTA’s, Pet Scans. |
| WELLS FARGO |
Requires authorization for MRI’s and PET Scan’s.
|
