Mount Sinai Radiology Insurance Information Insurance Carrier Plan Eligibility Precertification Precert. Phone Number 1199 Care to Care 1199 Home Care & Multiplan (646) 473-7160 Care to Care (888) 910-1199 CareCore Aetna HMO/PPO,MC POS (888) 632-3862 Provider ID# 4351108 Affordable Multiple Plan, First Health PPO & Workers Compensation AIM (866) 714-1107 NIA Amerigroup Medicaid HMO (800) 454-3730 Amidacare Medicaid HMO (800) 556-0674 No Authorization except for (800) 642-7565 or www.radmd.com NIA # 136171197 (888) 364-6061 Arch Care Beech Street Authorization letter is CT/CTA, MRI/MRA, NM, /US/XRAY Call insurance plan (866) 263-9083 Shield CT/CTA,,MRI/MR, NM (Heart only), All Plans require referral form for US /CT biopsy exams Certain plans require
Auth Shield EMPIRE CT/CTA, MRI/MRA, NM (Heart only), Referral form is for US / CT biopsy exams AIM (877) 430-2288 opt.1 Approve under NPI# 1568480523 Shield FEDERAL NO AUTH. REQUIRED Shield of New Jersey HORIZON CT/CTA, MRI/MRA, NM (Heart only), Referral form is for US / CT biopsy exams CareCore ProviderID#136171197 CCM- Comprehensive Care Management CCM (718) 515-8600 or (212)860-8200 Referral from CCM needed for all procedures (646)-536-5512 Commercial Ins. Call Insurance Plan Auth for certain services. CT/CTA, MRI,MRA, PET SCAN, US/XRAY Authorization is CT/CTA, MRI/MRA, MedSolutions Cigna HMO, POS, Open access & PPO (800) 244-6224 Film consults -No authorization - Interventional Radiology needs authorization (888)693-3297 from 8am-9pm or at: cigna.medsolutionsonl ine.com Fidelis Medicaid (888) 343-3547 Various requirements for exams Script is.
GHI (EMBLEM HEALTH) HMO, PPO, Comprehensive Benefits Plan (212)501-4444 Provider ID# 4102465 Great West Out-of-Network (800) 663-8081 Guardian (888) 693-3295 Health Plus Medicaid HMO (800) 450-8753 Authorization for: MRI/MRA, US-pregnant pelvis Referral for: All other procedures (800) 450-8753 opt. 3,7 Approve under NPI # 000424111179 Health first 65+, Medicaid HMO (888) 801-1660 Prescriptions needed for X-Ray/US Provider ID#163125A12 HIP EMBLEM HEALTH Medicaid HMO (800) 447-8255 HIP REFERRAL for US/ X- Rays If not handled by obtain referral from HIP / PCP Provider ID#136171197 PRIS# 39794P (Simpson, W. MD) Healthcare Partners HIP Healthcare Partners #701208 (516-746-2200) RM-REDS (Rabinowitz, J. MD) International Ins. Call Insurance Plan Auth for certain services CT/CRA, MRI/MRA, PET
SCAN, US/XRAY Magna Care Call insurance (800) 235-7267 Call insurance Medicare PART B (877) 869-6504 Medicaid New York Metro Plus Medicaid HMO (212) 908-3782 CT/CTA, MRI/MRA, NM (Heart only), (888) 209-4122 Metro Plus (800) 303-9626 Multiplan Call insurance plan Neighborhood Health & Medicaid HMO (800) 765-3805 www.getnhp.com and ULTRASOUND (800) 765-3805 NPI # 1568462802 No Fault Case must be open Letter of Medical Necessity is from the Primary Care Provider Oxford All plans accepted (800) 666-1353 Provider ID# A399401 PHCS All plans accepted Call insurance plan Pomco PPO Call insurance plan Select Health New York Medicaid HMO (212) 404-3177 (212) 404-1355
Presbyterian United Healthcare Empire Plan (888) 333-9067 opt. 3 (888) 333-9067 opt. 3 United Healthcare Choice Plus (Mount Sinai Employees) (877) 842-3210 United Healthcare New Jersey (877) 842-3210 Provider ID# 8453160 AARP United Healthcare Secure Horizons (877) 842-3210, opt. 2 (866) 889-8054 Evercare United Healthcare UMR (866) 893-4879 Auth for certain plans CT/CTA, MRI/MRA, PET SCAN (866) 893-4879 VNS Choice (866) 791-2215 Check for Authorization (866) 791-2215 Worker s Compensation MRI-All need Authorization EXCEPT EXAMS for BACK, NECK, SHOULDER OR KNEE CT-Authorization is if patient is having more than one CT exam, All NM and World Trade Center Authorization form is for all exams