| Insurance Company |
Notes |
| |
|
| AARP - Senior Secondary Plan |
AARP does not contract with facilities - secondary billing |
Accountable Health - PPO
Admar - PPO
ADNET
|
Auth for varies by payer; call to verify
Aut for varies by payer; call to verify
Auth req. |
| Aetna |
For Aetna HMO, Open Access HMO, QPOS and USAccess patients , call MedSolutions for Auth: 1-800-693-3211
For nuclear medicine, call Aetna to obtain a registration number at 1-888-239-1287 |
| ALMA |
Discount for cash on date of service. See ALMA fee schedule Pt. Will present ALMA Discount Card |
| American Care Source |
Authorization required for MRI and PET |
| AnciCare |
Aut varies by payer; call to verify |
| AZ Foundation for Medical Care |
Auth varies by payer; call to verify |
| AHCCCS |
Auth required as primary or secondary payer
Screening Mammograms covered for patients age 40 and over |
| AZ Medical Network (AMN/HMN) PPO |
Authorization varies by employer; call to verify |
| ASI Flex PPO |
Authorization varies by payer; call to verify |
| Banner Choice Plus (BPHO) |
Call to verify patient can come to TMC |
| Beech Street |
Authorization varies by payer; call to verify |
| Blue Cross/Blue Shield of AZ |
Auth varies by payer; call to verify |
| Catholic Healthcare West Employees (Arizona Foundation for Medical Care) |
Call Schaller Anderson to verify what authorizations are required and if TMC can see patient |
| Care First of Arizona |
Auth required for CT |
| Cigna Healthcare AZ (MedSolutions) Note: All Cigna MRI, CT and PET MedSolutions is the Plan |
Call MedSolutions for authorization at 1-888-693-3211
This applies to all products except EPO, PPO, Open Access Plus and Indemnity OSNA referrals only |
| Community Care Network (CCN) PPO |
Auth varies by employer; call to verify |
| Corvel |
Call Corvel to schedule |
| Diagnostic Radiology Network |
Auth varies by employer; call to verify |
| DISC Imaging Services |
Call DISC to schedule |
| First Health |
Auth varies by payer; call to verify |
| Fortified Provider Network |
Auth for MRI and PET |
| Galaxy Health Network |
No auth requirements for PPO
Work Comp Claim # for WC |
| Gallagher Bassett |
Carrier, Claim # and DOI for WC |
| GEHA-(MedSolutions) |
Auth required for CT, MRI, MRA, PET and Nuclear Cardiac Procedures.
Call MedSolutions at (866) 558-4314 |
| Great-West Healthcare (MedSolutions) |
All exams registered as MedSolutions. MRI/MRA, CT, PET require authorizations. |
| Health Choice - AHCCCS |
Auth required for MRI/MRA, 2nd and subsequent OB ultrasounds, Dexas under age 50, Spect scans, PET |
| Health Select (MIHS Employee Plan) |
Limited Sites see footnote 2. Authorization required for CT and MRI. Call CIGNA at 800-558-4314. |
| Health Net of Arizona |
Authorizations required CT, and MRI/MRA, MUGA Scans, nuclear cardiology, and PET through NIA |
| Humana (All Plans) |
|
| Integrated Health Plan |
Auth varies by payer; call to verify |
| Interplan |
Auth varies by payer; call to verify |
| Liens |
Direct all Lien requests to Steve Dorsey in the Business Office. |
| MMSI (formally Mayo Health Plan) |
Prior authorization requirements vary by payer; call MMSI to verify |
| Maricopa Integrated Health Plan |
No auth required |
| Maricopa Senior Select |
No auth required |
| Maricopa Long Term Care |
No auth required |
| Med-Eval |
Med-Eval will schedule directly |
| MedFin Manager |
MedFin must approve (See Christy at Central Scheduling) |
| Medicare |
No authorization requirements |
| Medicare Railroad |
No authorization requirements |
| MedFocus |
Call MedFocus to schedule |
| MedLink |
Call MedLink to schedule |
| Mercy Care Plan - AHCCCS |
Auth Required for MRI, MRA, and PET |
| Mercy Healthcare Group |
Auth Required for MRI, MRA, and PET |
| Midwest Diagnostic Management |
Call MDM to schedule |
| MultiPlan (U.S. Postal Workers) MedSolutions |
Call MedSolutions for authorization for all CT, MRI, PET, and nuclear cardiac imaging at 888-693-3211 |
| National Choice Care |
Call NCC to schedule |
| One Call Medical |
OCM will call and schedule |
| PacifiCare of Arizona |
Verify Eligibility: 800-283-7525 |
Commercial Networks
Metro Phoenix Network
Metro Plus
Open Access
POS
PPO
|
Copays vary by plan; call to verify
Auth varies by product; see above
Auth varies by product; see above
Auth required for MRI, MRA, PET and Spect
Auth varies by product; see above
Auth required for MRI, MRA, PET, and Spect
|
Senior Networks
Abrazo Network
East Valley Network
John C. Lincoln Netwrk
Scottsdale Network
Secure POS
St. Luke's
Thunderbird Network
|
Auth varies by product
Auth varies by product
Refer patients to Pacificare for Network Facility
Refer patients to Pacificare for Network Facility
Auth varies by product
Auth varies by product
Auth varies by product
|
| Phoenix Health Plan |
Auth required for MRI/MRA and PET |
| PPO Next |
Auth varies by payer, call to verify |
| Private Healthcare (PHCS) PPO |
Auth for MRI varies by payer, call to verify |
| Referral Management Systems |
Call RMS to schedule |
| Schaller Anderson |
Auth required for MRI, CT, PET |
| Signet Direct |
Auth required for CT, MRI, PET |
| State Compensation Fund |
Carrier, Claim # & DOI; bill claims to State Fund |
| Three Rivers Provider Network |
Carrier, Claim #, DOI; bill carrier on card |
| TRICARE |
OB/Ultrasounds are not covered unless medically necessary and authorized. Patient must be seen on base. |
| TRICARE CHAMPVA |
Authorization varies; call to verify |
| TRICARE for Life |
Authorization varies; call to verify
Medicare is primary, TRICARE is secondary |
| United Healthcare (All Products) |
No authorization required |
| USA Managed Care |
Auth for MRI varies by payer; call to verify |
| U.S. Postal Workers (MultiPlan) -- MedSolutions |
Call MedSolutions for authorization for all CT, MRI, PET and nuclear cardiac imaging at 888-693-3211 |
| West Coast Neurodiagnostics |
Auth required |
