New Rochelle Radiology TIN: 13-2673297 Precertification Requirements 175 Memorial Highway NPI: 1376539080 150 Lockwood Avenue NPI: 1003803784 PET/ Aetna through CareCore Aetna Golden icare through CareCore Affinity Health Plan 11 digit ID 866-242-5615 Affinity Health Plan Affordable Care/ObamaCare ID begins with H Precert required for all imaging studies 888-543-9074 -Ray Fluoroscopy Affinity Health Plan icare ID has an M in the middle 866-242-5615 Anthem Blue Cross Blue Shield Through AIM 866-714-1107 Beech Street PPO BlueCard SWSCHP Prefix TUR Through Coordinated Health/Care 1-888-779-7247 1
PET/ Blue Cross/Blue Shield Most Plans Require Precert Through AIM 877-430-2288 Blue Cross/Blue Shield Senior Plan/ VOF plans Through AIM 877-430-2288 Blue Cross/Blue Shield Federal Plan ID begins with R No Precert required CenterLight Healthcare Formerly CCM 800-695-1035 Christian Brothers 866-458-4002 CIGNA HMO Through Solutions 888-693-3297 Cigna.medsolutionsonlin e.com CIGNA PPO Precert required for some plans. If not indicated on back of card, you must check 800-224-6224 Connecticare Through NIA 1-877-607-2363 When more frequent than 1 in 23 mos Elderplan- Only 175 office par Through Care To Care 866-390-7526 EmblemHealth EPO, PPO, 800-420-3471 2
PET/ Empire Government Plan United HealthCare Benefits Management 1-888-333-9067 Fidelis Care 888-343-3547 Precert req for Hysterosalpingograms Inj CPT 58340 when not being done for cancer not req when cancer diagnosis (140.x 239.x) First Health Precert 866-214-8701 Varies from plan to plan GHI through CareCore GHI HMO through CareCore HIP through CareCore 866-417-2345 Req. referral for all radiology studies that do not require precert - except screening mammo Referral not required for: Access 1 and II, EPO, PPO, VIP HIP Montefiore IPA Through the IPA 914-377-4400 Referral not required Needed for MRI Only. (Not ) Health First - 3
PET/ Health Republic 888-610-0102 Through NIA 866-392-5173 eff 8/1/15 Health Republic of NJ 888-990-5706 x Hudson Health Plan eff 7/1/14 866-665-8341 Humana/ChoiceCare Comm and Mcare plans Updated 9/14/13 RadConsult 1-866-825-1550 Local 1199 Through Care To Care 888-910-1199 Must Have Patient s SS#! Cardiology Eff 11/1/12 Locals Varies from plan to plan. Contact number on card. MVP all plans 4/1/12 Through CareCore 800-568-0458 MagnaCare precertification varies from plan to plan Must Have Patient s SS# and the phone number of the local! MagnaCare/Pavers and Builders 866-624-6275 4
PET/ icaid-through RadConsult 888-209- 4122 or fax 888-209-9634 MultiPlan precertification varies from plan to plan Oxford PHCS varies from plan to plan Pavers and Builders/ MagnaCare 866-624- 6275 POMCO varies from plan to plan. To check requirements 900-766-2687 Authorization 800-766-2648 Precert strongly advised SWSCHP BlueCard TUR Through Coordinated Health/Care 1-888-779-7247 Touchstone Through Care to Care 1-888-390-7526 Touchstone Through Touchstone 1-888-777-0350 Tricare/US Family Health Pre-certification varies based on C.P.T. code. 866-390-0933 referral required for some studies. No precert req 70,000 series Diagnostic Mammo 5
PET/ United Healthcare Pre-notification through UHC 1-866-889-8054 eff 8/13/12 To determine if required: 877-842-3210 United Healthcare Community Plans Pre-certification through UHC 1-866-889-8054 United Healthcare Navigate 1-866-889-8054 Through UHC WellCare 888-333-8641 Effective 3/2/09 6