Participating Insurance Plans
| Insurance Company | Plan Type | Insurance Referral & Pre-Certification Requirements |
|---|---|---|
| Aetna | HMO, PPO, EPO, Medicare Advantage | Pre-certification required for MRI, MRA, CT, CTA. Contact Info: eviCore 1-888-693-3211 Website: https://www.evicore.com HSG only for infertility – Aetna HMO only – Patient to call 1-800-575-5999 For 2nd or more OB sono, patient to call phone number on back of insurance card. |
| Anthem BS of Virginia | Indemnity | Health Services Review required for MRI, MRA, CT, CTA, HSG for infertility examination or treatment. Contact Info: Anthem 1-800-533-1120 Website through AIM: https://www.providerportal.com |
| Anthem HealthKeepers | HMO, POS, Excludes 'Plus' Medicaid product | Health Services Review required for MRI, MRA, CT, CTA, HSG for infertility examination or treatment. Contact Info: Anthem 1-800-533-1120 Website through AIM: https://www.providerportal.com |
| Anthem KeyCare | PPO | Health Services Review required for MRI, MRA, CT, CTA, HSG for infertility examination or treatment. Contact Info: Anthem 1-800-533-1120 Website through AIM: https://www.providerportal.com For 3rd or more OB sono, patient to call the phone number on the back of insurance card. |
| CareFirst BlueChoice | HMO, POS | No pre-certification requirements. |
| CareFirst BluePreferred PPO | PPO | No pre-certification requirements. |
| CareFirst BS NCA | Indemnity | No Pre-certification requirements.
|
| ChoiceCare | Humana Network | PPO | Member should contact ChoiceCare for pre-certification guidance. Contact Info: ChoiceCare 1-866-825-1550 Website: https://www.choicecarenetwork.com |
| Cigna | PPO, HMO, POS | Pre-certification is required for MRI, MRA, CT, CTA, HSG for infertility examination or treatment. Contact Info: eviCore 1-888-693-3211 Website: https://www.evicore.com |
| Cigna | APWU Employer Group Only | APWU Employer Group | Pre-certification required for MRI, MRA, CT, CTA, HSG. Contact Info: Care Allies 1-800-582-1314 Website: https://www.careallies.com |
| Cigna | Samba Employer Group Only | Samba Employer Group | Pre-certification required for MRI, MRA, CT, CTA, HSG. Contact Info: Care Allies • 1-800-582-1314 Website: https://www.careallies.com |
| Compass Rose Health Plan | UMR | PPO | Member should call the home plan phone number on the back of the insurance card for pre-certification guidance. |
| Foreign Service Benefit | PPO | Pre-certification required for MRI, MRA, CT, CTA, HSG. Contact Info: Foreign Service 1-800-593-2354 |
| John Hopkins Health Plan EHP | PPO | Pre-certification is required for MRI, MRA, CT, CTA, HSG for infertility examination. Contact Info: 1-800-261-2393 Website: https://hopkinsmedicine.org/johns_hopkins_healthcare |
| John Hopkins US Family Health Plan | TRICARE HMO | Pre-certification is required for MRI, MRA, CT, CTA, HSG for infertility examination. Contact Info: 1-800-808-7374 Website: https://www.hopkinsmedicine.org/john_hopkiins_healthcare |
| Kaiser Permanente | HMO, POS | Authorized referral is required for all exams with the exception of screening mammograms. |
| Mail Handlers | PPO | Pre-certification is required for MRI, MRA, CT, CTA, HSG. Contact Info: Mail Handlers 1-800-410-7778 |
| MDIPA | Washington Radiology Offices in Maryland | Preferred POS Only | For access to Washington Radiology's Maryland clinical offices, plan must state 'Preferred' and card must state 'RAD=MONT.' Pre-certification is required for CT of the brain, chest, musculoskeletal, colonography, abdomen/pelvis (without contrast); MRI of the brain, musculoskeletal, heart; HSG for infertility examination or treatment. Referral is required for MRI of breast, neck, face, orbits, IACs; MRA of the head. Contact Info: 1-877-842-3210 Website: https://www.unitedhealthcareonline.com |
| MDIPA | Washington Radiology Offices in Virginia and D.C. | HMO, POS | For access to Washington Radiology's Virginia clinical offices, card must state 'RAD=NOVA.' In D.C., card must state 'RAD=DC.' Pre-certification is required for CT of the brain, chest, musculoskeletal, colonography, abdomen/pelvis (without contrast); MRI of the brain, musculoskeletal, heart; HSG for infertility examination or treatment. Referral is required for MRI of breast, neck, face, orbits, IACs; MRA of the head. Contact Info: 1-877-842-3210 Website: https://www.unitedhealthcareonline.com |
| Medicare | PPO | Pre-Certification requirements vary. Members should check with their insurance company. See phone number on the back of insurance cars. Website: https://www.multiplan.com |
| OneNet PPO | PPO | Pre-certification requirements vary. Members should check with their benefits manager or call the member service number listed on their card. |
| Optimum Choice, INC. | Washington Radiology Offices in Maryland Only | Preferred POS Only | For access to Washington Radiology's Virginia clinical offices, card must state 'Preferred' and card must state 'RAD=MONT.' Prior notification is required for MRI, MRA, CT, CTA, 3D Rendering, HSG for infertility or treatment. Contact Info: MDIPA 1-877-842-3210 Website: https://www.unitedhealthcareonline.com |
| Optimum Choice, INC. | Washington Radiology Offices in Virginia and DC Only | HMO, POS | For access to Washington Radiology's Virginia clinical offices, card must state 'RAD=NOVA.' In DC, card must state 'RAD=DC.' Prior notification is required for MRI, MRA, CT, CTA, 3D Rendering, HSG for infertility or treatment. Contact Info: MDIPA 1-877-842-3210 Website: https://www.unitedhealthcareonline.com |
| Peace Corps Health Benefit Program | Private | Insurance referral is required for all exams. |
| Private Healthcare Systems | PHCS | PPO | Pre-certification requirements vary. Members should check with their Employee Benefits Plan Manager. See the phone number listed on the back of insurance card. Website: https://www.phcs.com |
| TRICARE Standard | Government | No pre-certifications requirements. |
| United Healthcare Choice | Select | HMO, PPO, POS, Excludes Medicaid Product | Prior notification is required for MRI, MRA, CT, CTA, 3D Renderings. Contact Info: 1-866-899-8054 Website: https://www.unitedhealthcareonline.com |
| United Healthcare Choice | Select | GEHA Employer Group Only | GEHA Employer Group | Pre-certification is required for MRI, MRA, CT, CTA. Contact Info: eviCore 1-888-693-3211 Website: https://www.evicore.com |
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