Careers

 

Referring Physicians Guide  >  Participating Insurance Plans

Participating Insurance Plans

Company Plan Type Inusrance Referral & Precertification Requirements
Aetna HMO/PPO/EPO Precertification required for MRI,MRA, CT, CTA, PET/CT, and Nuclear Medicine.
Pre-Cert Contact Info: CareCore National • 1 877-732-3862
Pre-Cert Website: https://www.carecorenational.com
HSG only for infertility – Aetna HMO only – call 1 800-575-5999.
OB sono 2nd or more – see phone number on back of insurance card.
Anthem BS of Virginia Indemnity Health Services Review required for MRI,MRA, CT, CTA, PET/CT, and Nuclear Medicine.
Pre-Cert Contact Info: Anthem • 1 800-533-1120
Pre-Cert Website: https://poc.anthem.com/POC/Login/POC_Login.jsp
OB sono 2nd or more – see phone number on back of insurance card.
Anthem HealthKeepers HMO/POS Health Services Review required for all imaging studies except x-ray,mammography, and routine
OB ultrasound (CPT 76801& 76805). HSG only for infertility.
Pre-Cert Contact Info: Anthem • 1 800-533-1120
Pre-Cert Website: https://poc.anthem.com/POC/Login/POC_Login.jsp
OB sono 2nd or more – see phone number on back of insurance card.
Anthem KeyCare PPO Health Services Review required for MRI,MRA, CT, CTA, PET/CT,Nuclear Medicine, detailed
OB ultrasound (CPT 76811), and Nuchal Translucency. HSG only for infertility.
Pre-Cert Contact Info: Anthem • 1 800-533-1120
Pre-Cert Website: https://poc.anthem.com/POC/Login/POC_Login.jsp
OB sono 2nd or more – see phone number on back of insurance card.
BCBS Out-of-State Plans PPO/HMO/POS Member should contact the home plan listed on back of the card for precertification guidance.
Pre-Cert Contact Info: See phone number on back of insurance card.
Pre-Cert Website: Varies by state.
CareFirst BS NCA Indemnity None
CareFirst BluePreferred PPO PPO None
CareFirst BlueChoice HMO/POS None
Choice Care PPO Precertification requirements vary. Members should check with their insurance company.
HSG needs authorization.
Pre-Cert Contact Info: See phone number on back of insurance card.
Pre-Cert Website: https://www.choicecarenetwork.com
CIGNA PPO/HMO/POS Precertification required for MRI,MRA, CT, CTA, PET/CT,Nuclear Medicine and HSG.
Pre-Cert Contact Info: MedSolutions 1 888 693-3211 • DC residents 1 800-541-7526
Pre-Cert Website: https://www.medsolutionsonline.com
HSG – Cigna – call 1 800-244-6224.
If no authorization is needed, registration is still necessary through MedSolutions.
Community Care Network (CCN) PPO None
First Health Network PPO None
Kaiser Permanente HMO/POS Insurance referral required for all exams with the exception of screening mammograms.
MAMSI Life and Health PPO Precertification required for infertility services.
Pre-Cert Contact Info: MDIPA • 1 800-342-6141
Pre-Cert Website: https://www.mdipa.com
MDIPA
(WRA Offices in Virginia and DC)		 HMO/POS For access to WRA’s Virginia offices, card must state RAD=NOVA. In DC, card must state RAD=DC. Precertification required for CT of the brain, chest, musculoskeletal, colonography, abdomen/ pelvis (without contrast); MRI of the brain, musculoskeletal, and heart; PET/CT(non-cancer diagnosis); HSG only for infertility.
Pre-Cert Contact Info: MDIPA • 1 800-342-6141
Pre-Cert Website: https://www.mdipa.com
MDIPA
(WRA Offices in Maryland)		 Preferred POS Only For access to WRA’s Maryland office, plan must be “preferred” and card must state RAD=MONT. POS Only Precertification required for CT of the brain, chest, musculoskeletal, colonography, abdomen/pelvis (without contrast); MRI of the brain, musculoskeletal, and heart; PET/CT (non-cancer diagnosis); HSG only for infertility.
Pre-Cert Contact Info: MDIPA • 1 800-342-6141
Pre-Cert Website: https://www.mdipa.com
Medicare Government None
MultiPlan PPO Precertification requirements vary. Members should check with their insurance company.
Pre-Cert Contact Info: See phone number on back of insurance card.
Pre-Cert Website: https://www.multiplan.com
NCPPO / UniCare / WellPoint PPO Precertification required for MRI,MRA, CT, CTA, PET/CT, and Nuclear Medicine.
Pre-Cert Contact Info: RQI issued by American Imaging Management • 1 866-714-1101
Pre-Cert Website: https://www.providerportal.com/Default.aspx
OneNet PPO (Alliance) PPO GEHA Employer Group: Precertification required for MRI,MRA, CT, CTA, PET/CT,Nuclear Medicine and HSG.
Pre-Cert Contact Info: MedSolutions • 1 866-879-8317; HSG see phone number on back of insurance card.
Pre-Cert Website: https://www.medsolutionsonline.com
    APWU Employer Group: Precertification required for MRI,MRA, CT, CTA, PET/CT,Nuclear Medicine and HSG.
Pre-Cert Contact Info: MedSolutions • 1 866-693-3298; HSG see phone number on back of insurance card.
Pre-Cert Website: https://www.medsolutionsonline.com
    Guardian: Precertification required for PET/CT.
Pre-Cert Contact Info: See phone number on back of insurance card.
Pre-Cert Website: http://www.onenetppo.com/onenet/index.jsp
Optimum Choice, Inc.
(WRA Offices in Virginia and DC)		 HMO/POS For access to WRA’s Virginia offices, card must state RAD=NOVA. In DC, card must state RAD=DC. (WRA Offices in Virginia and DC) Precertification required for CT of the brain, chest, musculoskeletal, colonography, abdomen/pelvis (without contrast); MRI of the brain, musculoskeletal, and heart; PET/CT (for non-cancer diagnosis); HSG only for infertility.
Pre-Cert Contact Info: 1 800-342-6141
Pre-Cert Website: https://www.mdipa.com
Optimum Choice, Inc.
(WRA Offices in Maryland)		 Preferred POS Only For access to WRA’s Maryland offices, card must be “preferred” and state RAD=MONT. (WRA Offices in Maryland) POS Only Precertification required for CT of the brain, chest, musculoskeletal, colonography, abdomen/pelvis (without contrast); MRI of the brain, musculoskeletal, and heart; PET/CT (for non-cancer diagnosis); HSG only for infertility.
Pre-Cert Contact Info: 1 800-342-6141
Pre-CertWebsite: https://www.mdipa.com
Peace Corps Health Benefit Program Private Insurance referral required for all exams.
Private Healthcare Systems (PHCS) PPO Precertification requirements vary. Members should check with their Employee Benefits Plan manager.
Pre-Cert Contact Info: See phone number on back of insurance card.
Pre-Cert Website: https://www.phcs.com
Railroad Medicare Government None
TRICARE Standard Government None
United Healthcare Choice/Select HMO/PPO/POS Prior notification required for MRI,MRA, CT, CTA, PET/CT, and Nuclear Medicine.
Pre-Cert Contact Info: 1 866-889-8054
Pre-Cert Website: https://www.unitedhealthcareonline.com