Aetna
HMO, EPO, PPO and Medicare products (Not PAR with NSLIJ)
Authorization thru CareCore National, LLP for CT/CTA, MRA/MRI, Nuclear Medicine and PET
Aetna - Indemnity Traditional choice
Affinity Health Plan
Authorization thru CareCore National, LLP for CT/CTA, MRA/MRI, PET and Nuclear Medicine (effective 08/03/09)
AmeriChoice by United Healthcare
Authorization for CT/CTA, MRA/MRI, PET and Nuclear Medicine for Medicaid, FHP and CHP members
American Imaging Management (AIM)
Radiology MSO for Empire BCBS
AmeriHealth Administrators
Authorization for MRA and PET
Beech Street
Please refer to back of patient's card
Care-to-Care
Radiology MSO for 1199
Authorization for CT/CTA, MRA/MRI and PET
CareCore National, LLP
Radiology MSO for AETNA, GHI, Healthfirst, HealthNET, HIP and Oxford
Comprehensive Care Management (CCM)
Referrals required for ALL procedures
ChoiceCare PPO (Product of Humana)
Authorization for CT/CTA, MRA/MRI, Nuclear Cardiology and PET
CIGNA HMO, POS, Network, Network POS, Open Access Plus, PHS+ (Personal Health Solutions Plus)
Authorization thru American Imaging Management (AIM) for CT/CTA, MRA/MRI, Nuclear Cardiology, PET and if back of patient’s card states “Inpatient Admission and Outpatient Procedures”
CIGNA PPO, EPO and Indemnity
Authorization through MedSolutions. Please refer to back of patient’s card.
Crossroads (formerly VISTA Plan Administrators)
Local 812-Soft Drink & Brewery Workers
Easy Choice Health (formerly known as Atlantis Health Plan)
Authorization for Bone Scan, CT/CTA, MRA/MRI, Nuclear Medicine, 3rd OB Sono and PET
Emblem Health
PAR - Please refer to HIP and GHI
Empire BlueCross BlueShield
ALL PRODUCTS - HMO/POS Plans
Authorization thru American Imaging Management (AIM) for CT/CTA, MRI/MRA, Nuclear Cardiology and PET
Fidelis Care NY
ALL PRODUCTS - Authorization for Biopsies and PET
First Health (formerly Affordable)
GHI HMO/PPO/Emblem Health
Authorization thru CareCore National for CT/CTA, MRA/MRI, Medicine and PET
Great West (formerly One Health)
Authorization thru MedSolutions for CT/CTA, MRA/MRI and PET
HealthCare Partners, IPA (formerly Heritage)
NON-PAR - HIP Health Plan of New York and Liberty Health Advantage (Medicare product for NYC and Nassau counties)
Automatic Referral Authorization for plain film x-rays (chest, skull and extremities), screening mammograms and ultrasounds (excluding cardiac echo/carotid and venous dopplers)
ALL OTHER PROCEDURES REQUIRE AUTHORIZATION
Healthfirst-Medicare, PPO, PPO Select, 65+, Healthy NY, Medicaid Family Health Plus, ChildHealth Plus
Authorization for CT/CTA, MRA/MRI, Nuclear Cardiology, 3rd OB Sono and PET thru CareCore National, LLP
HealthNET (formerly PHS)
Authorization for CT/CTA, MRA/MRI, Nuclear Medicine, 4th OB Sono and PET thru CareCore National LLP
HealthPlus - ALL PRODUCTS (NOT PAR in Suffolk County locations)
Authorization for MRI/MRA, 3rd OB Sono and PET
HIP/Emblem Health (NOT par with Perfect Health, Smart Start or HealthCare Partners)
Authorization thru CareCore National, LLP for CT/CTA, MRA/MRI, Nuclear Medicine, 4th OB Sono and PET
Queens LI Medical Group Members (QLIMG)
Authorization thru QLIMG
Island Group Administrators
Please refer to back of patient’s card
LOCAL 1115
Authorization thru MedFocus
LOCAL 1199
Authorization thru Care-to-Care
MagnaCare, MagnaHealth, PPO/HMO
MedFocus
Radiology MSO for Locals 1115 and 1199
Medicaid
Authorization for CT/CTA, MRA/MRI, Nuclear Medicine and PET through RadConsult (as of 4/1/2011)
Medicare
MedSolutions
Radiology MSO for Cigna.
MetraComp, Inc. (Workers’ Comp. PPO Network)
Please refer to back of patient’s card
Multi-Plan (par with Perfect Health)
Please refer to back of patient’s card
National Imaging Associates (NIA)
Radiology MSO for Horizon Healthcare of NY
No Fault
By individual carrier
Oxford Health Plans
Authorization for CT/CTA, MRA/MRI, Nuclear Medicine, 4th OB Sono, 3D Reconstruction and PET thru CareCore National, LLP
Oxford as Secondary
Authorization same as above
REFERRALS required for ALL CPT codes outside 70,000 series (referral required by procedure)
Group #ANC 1156
PHCS (Private HealthCare Systems)
Patient responsible to check authorization required
Please refer to back of patient’s card
Railroad Medicare (Palmetto GBA)
SPREEMO (Worker’s Comp MSO)
Suffolk Health Plan (Medicaid, Child Health Plus, Family Health Plus)
Please refer to back of patient’s card
TechHealth (Worker’s Comp MSO)
Three Rivers Provider Network
Please refer to back of patient’s card
United Healthcare
ALL PRODUCTS
United Healthcare-The Empire Plan
Authorization for CT/CTA, MRA/MRI, Nuclear Cardiology, Nuclear Medicine and PET
US Imaging Network, LLC
Authorization needed for all procedures
Vytra Health Plans
ALL PRODUCTS (Except HMO and Smart Start)
Workers’ Compensation
Authorization for CT/CTA and MRA/MRI by individual carrier
