Auth requirements:

Health Choice/Health Choice Generations: OB US is 5-7 days TAT, DUPLEX/DOPPLER is 5-7 day minimum TAT

Tricare: All US, MG, BD, MRI & CT require auth- 14 days minimum TAT

Alignment: US- 7 days minimum TAT

Optum: MRI, NM, PET, CTA, MRA is 14 days minimum TAT (In Nevada ONLY: Out of network for all PET, NM & US except ABI, Arterial, Venous mapping and Prostate and out of network for ALL CT except CT lung, CTA for PE, CTA runoff and patients over 400 lbs.  

Mercy Care/Mercy Care Advantage: US (Elastrography) cpt 76981 is a 14 day minimum TAT

Scan Health: ALL Breast Imaging - 7 day minimum TAT

Humana: All CT/A, MRI/A, NM Modalities are 5-7 days.

Humana FL (Only) All modalities - Schedule 9 days out.  Add-Ons ONLY allowed if patient has referral/authorization number on hand.

COMMONLY MISCHEDULED PROCEDURES

State Medicaid is NOT covered outside of the issued state

If patient has a Medicaid/State Funded insurance plan, they cannot be offered self-pay as another option.

SimonMed Imaging TAX ID: 45-3727094   NPI: 1477830818

florida non par insurances

Hillsborough County Insurance is not accepted in the Tampa Area (Sun City Center, Brandon, Tampa, MacDill and Carrollwood)

United Healthcare policy with group #FLONEX is not accepted in Florida

Oscar health Insurance 

SCHEDULE 10-14 BUSINESS DAYS OUT

The Florida sites below are contracted with Oscar Health Insurance. 

Ø  Tampa

Ø  MacDill

Ø  Carrollwood

Ø  Lakewood Ranch

Ø  Sarasota

Ø  Sarasota Springs

Ø  St Petersburg

Ø  Brandon

Ø  Jacksonville

Ø  Naples

Ø  Park South( Bradenton)

Ø  Port Charlotte

Ø  Sun City

Ø  The Villages

Hillsborough County Insurance is not accepted in the Tampa Area (Sun City Center, Brandon, Tampa, MacDill and Carrollwood)