Insurance/ Managed Care

Clinical Diagnostic Radiology and Nuclear Medicine Ltd. is a preferred provider for many managed care plans. We own and operate our own billing department with trained staff to help with all your billing questions. Our central billing phone number is 602-604-7333. Any referral or authorization requirements will be addressed when either patients or referring doctor's offices schedules their appointments. All referrals and authorizations must be submitted prior to time of exam.

CDR is a provider for all of the following organizations (SUBJECT TO CHANGE WITHOUT NOTICE):

• ACCOUNTABLE HEALTH PLANS
• ADMAR (MED NETWORK)
• AETNA HEALTH PLANS
• AMERICAN SPECIALTY
• AMN / RAN HMA
• AZ FOUNDATION FOR MEDICAL CARE (ALL PLANS)
• AZ PHYSICIAN PLANS (AP/IPA, AP/HCG, AP/PSP)
• BANNER CHOICE PLUS (Authorization needed on OB US exams only)
• BC/BS OF AZ
• BEECH STREET (CAPP CARE)
• CARE FIRST
• CCN (COMMUNITY CARE NETWORK)
• CHS/IHS
• CIGNA COMMUNITY CHOICE
• CIGNA
• DES PROGRAMS
• FIRST HEALTH
• GALAXY NETWORK
• HEALTH NET
• HUMANA
• INDUSTRIAL CARRIERS
• LIFEMARK HEALTH PLAN
• LIFEWISE (Effective 5/1/2005)
• MAYO HEALTHCARE NETWORK
• MEDFOCUS
• MEDICARE
• MEDSOLUTIONS (Aetna, United Healthcare and Cigna Contracts)
• MERCY CARE PLANS (AHCCCS; HCG; PSP)
• MULTIPLAN
• MUTUALLY PREFERRED (MUTUAL OF OMAHA)
• NATIONAL MEDICAL LEINS
• ONE HEALTH PLANS
• PACIFICARE
• PHCS (PRIVATE HEALTH CARE SYSTEMS)
• PREFERRED PLAN OF AZ
• PRINCIPAL HEALTHCARE (PRINCIPAL FINANCIAL)
• RAILROAD MEDICARE
• SCHALLER ANDERSON
• SPECIALTY MANAGED CARE NETWORK
• STATE AHCCCS
• TRICARE (STANDARD; PRIME: WITH PRIOR AUTHORIZATION ONLY; TRIWEST; CHAMPUS)
• UNITED HEALTHCARE
• USA MANAGED CARE

CDR INSURANCES THAT REQUIRE PRE-AUTHORIZATION
(Subject to change without notice)

• ACCOUNTABLE

LISTED ON BACK OF CARD. VARIES PER CARD

• ADMAR

CT AND ALL EXAMS OVER $200.00 (VARIES PER PAYOR GROUP)

• AETNA HMO
  (US HEALTHCARE)

ALL NON CAPITATED SERVICES INCLUDING OBSTETRICAL US , STEREOTACTIC BREAST BIOPSY, NUCLEAR MEDICINE STRESS TEST, THALLIUM STUDIES, CARDIAC BLOOD POOL IMAGING, AND THERAPEUTIC NUCLEAR MEDICINE STUDIES, INFERTILITY SERVICES, MRI OF SPINE, OR LOWER EXTREMITY, MRA, PET SCANS, ULTRA FAST CT SCAN OF CHEST, PAIN MANAGEMENT, ALL OUT OF NETWORK PROVIDERS.

• AMN/RAN

ALL CT SCANS, MRI'S, PET SCANS (VERIFY ALL OTHERS.

• BANNER CHOICE PLUS

PET SCAN SERVICES

• BLUE CROSS
  BLUE SHIELD

MRI'S FOR BLUE CHOICE, BLUE SELECT, MEDICARE BLUE, AND POS PLANS. VERIFY AUTHORIZATION REQUEST FOR OUT-OF-STATE PLANS.

• CIGNA

NUCLEAR MEDICINE STRESS TESTS, HYSTEROSALPINGOGRAMS/ OR INFERTILITY TREATMENT, PAIN MANAGEMENT TREATMENT. (CIGNA PPO MAY NEED AUTHORIZATION FOR DEXA. PLEASE CALL TO VERIFY). OUTPATIENT SURGERIES/PROCEDURES

• CCN

ALL CT SCANS, DEXAS, MYELOGRAMS (NASE CCN DOES NOT NEED AUTHORIZATION FOR DEXA)

• DDSA

EVERY EXAM REQUIRES AUTHORIZATION VOUCHER.

• HUMANA

FETAL BIOPHYSICAL PROFILE, MYELOGRAPHY, NUCLEAR MEDICINE PROCEDURES, CT SCANS OF CHEST, ABDOMEN, PELVIS, HEAD, NECK OR SPINE.

• HEALTH NET

ALL CT SCANS, MRI'S, DEXAS, NUCLEAR MEDICINE PROCEDURES (THALLIUM, MUGA, PET SCANS) HYSTEROSALPINGOGRAMS.

• AZ FOUNDATION FOR MEDICAL CARE

CT SCANS VARY BY PAYOR, NEED TO VERIFY PRIOR TO STUDY.

• MERCY CARE

AMNIOCENTESIS, STEREOTACTIC BREAST BIOPSY, ULTRASOUND GUIDED ASPIRATIONS AND BIOPSIES.

• MERCY CARE
  PREMIUM SHARING

CAROTID ULTRASOUND, ALL CT SCAN PROCEDURES

• LIFEMARK

CT SCANS, MRI'S, NUCLEAR MEDICINE STUDIES, INVASIVE RADIOLOGY STUDIES

• PACIFICARE

DEXAS, CARDIAC TREADMILL TESTS, NUCLEAR STRESS TESTS, HYSTEROSALPINGOGRAMS, AND AMNIOCENTESIS.

• REFUGEE PROGRAM

ALL NON-ROUTINE PROCEDURES. ANY SERVICE $300+ MORE. HOSP OUTPT SERVICES. ALL INTERVENTIONAL SERVICES.

• SCHALLER ANDERSON

DEXAS, HYSTEROSALPINGOGRAMS, ANY PROCEDURE OVER $300.00, EXCEPT FOR CT SCANS