Participating Health Plans – Oaks and Suntree

Atop

• AARP Medicare Complete (United Healthcare line) (Auth required for CT, MRI/MRA, NUCMED, ECHO, STREE ECHO)
• AARP Medicare Supplemental
• Accountable (AHP)/now Interplan (IHG)
• ACS – Ancillary Care Services
• Advantra Freedom/Coventry (Medicare Advantage PFSS)
• AHC/Multiplan
• Aetna HMO/PPO – Prov #0801921 PPO Prov#4623394 (Auth required for CT, MRI/MRA, NUCMED, ECHO, STRESS ECHO)
• Aetna/SRC (Auth required for CT, MRI/MRA, NUCMED STRESS, ECHO, STRESS ECHO)
• Aetna Health Inc (Medicare HMO) (Auth required for CT, MRI/MRA, NUCMED STRESS, ECHO, STRESS ECHO)
• Aetna Global (Auth required for CT, MRI, NUCMED, ECHO, STRESS ECHO)
• Aetna Student Health
• Affordable Healthcare Options
• All Rad Direct PPO (Auth required for CT, MRI/MRA, NUCMED STRESS)
• American Medical Security (AHP/PHCS)
• Ancicare/Work Comp (Auth required for everything)
• Anthem BCBS (NO AUTH needed but pre-determination is recommended through their pre-determination line)
• APWU(Beechstreet)
• APWU/Multiplan (for other imaging)
• APWU (Auth required for CT, MRI/MRA, NUCMED CARDIO thru MedSolutions)
• Auto Insurance PIP
• AVALON HEALTHCARE (Auth required for CT, MRI/MRA, NUCMED)
• AVMED Provider #297455 (Auth required for CT, MRI/MRA, NUCMED, ECHO, STRESS ECHO)
• AVMED (NIA) Auth required for CT, MRI/MRA, NUCMED STRESS, STRESS ECHO)
• AVMED (PHCS) (Auth required for CT, MRI/MRA, NUCMED STRESS)

Btop

• Beechstreet
• BCEemergis/Multiplan
• Benesight
• Blue Cross Blue Shield – Oaks Provider #V2480            Suntree Provider #V000T
• Blue Cross Blue Options (Auth required for CT, HSG, MRI/MRA, NUCMED STRESS)
• Blue Cross Health Options (Auth required for CT, MRI/MRA, NUCMED STRESS)
• BCBS Northrop (Alpha Prefix NGO) (Must call to verify Auth requirements some needs pre-determination)
• BUPA/UHC

Ctop

• Care Credit
• Care Plus (Auth required for ALL High-tech exams)
• CCN
• Champva
• ChoiceCare “Network” PPO (NOT local Choice Care “Health plan HMO”)
• Cigna HMO
• Cigna PPO (Auth required for CT, MRI/MRA, NUCMED STRESS)
• Cigna International
• Cigna Samba Health Benefit Plan
• Citrus Care-All billed to MedSolutions (Auth required for CT, MRI/MRA, NUCMED)
• Clear Channel Health Benefit Plan (Meritain Health) uses Aetna as network
• Coast2Coast
• Combined Insurance/Medicare supplemental (NO AUTH required, covers Medicare deductible and coins)
• Commonwealth Service Center (Auth required for CT, MRI/MRA)
• Companion Life (uses Allied National as 3rd party. Claims to Allied)
• Connecticare (supplemental to Medicare) we are non part, check if patient has out of network benefits
• Connecticut General Life Ins (Cigna Product):
• Consolidated
• Core Choice
• Coresource/Aetna
• Coresource (PHCS/CCN)
• Core Value (Product of American Medical & Life Insurance that uses Multiplan network)
• Coventry/NIA (Advantra Freedom/Vista Health plans / Medicare Advantage) (Auth required for CT, MRI/MRA, NUCMED STRESS)
• Cypress Care

Dtop

• Difinity Health (UHC) (Auth required for CT, MRI/MRA, NUCMED STRESS)

Etop

• Empire Plan/UHC: (Auth required for most contracts- CALL Empire)
• ESIS/Workers Comp (Auth required for everything)
• Evercare/Medicare Replacement (Auth required for CT/CTA, MRI/MRA, NUCMED STRESS)
• Evicore Healthcare (formerly Med Solutions)
• Evolution Health Care

Ftop

• FC Diagnostics
• Fellowship Radiology-Workers Comp
• First Health/Health and Welfare Benefit Systems
• First Health/Florida Hospital Healthcare System (Auth required for CT, MRI/MRA, NUCMED)
• First Health/Atlantic Medical (Auth required for CT, MRI, NUCMED)
• Florida Healthcare Plan (FHCP/BC)
• Florida Healthcare Plus/Medicare Advantage Plan
• Florida League of Cities
• Foreing Service Benefit Plan – uses Aetna as network (PAR)
• Freedom Health/Medicare Replacement (Auth required for ALL high-tech exams)
• Freedom Health/Optimum Health (Auth required for MRA)
• Freedom Life Insurance Company/Multiplan

Gtop

• Gallagher Benefit through First Health or PHCS
• GEHA (Auth required for CT, MRI, NUCMED STRESS-thru MedSolutions)
• GENEX-W/COMP
• GHI (Secondary to Medicare)
• GHI (NOT A PROVIDER –must verify if patient out-of-network benefits, they will pay the patient who will in turn reimburse UCI)
• Gil Sbar Insurance/Cofinity
• Golden Rule/United Healthcare
• Great West (Auth required for CT, MRI, NUCMED STRESS-thru MedSolutions)
• Guardian Healthcare

Htop

• Hartford
• Harvard Pilgrim (Auth required for CT, MRI/MRA, NUCMED SRESS)
• Harvard Pilgrim/First Seniority Freedom Premier (Medicare Replacement)
• Health and Welfare
• Healthease HMO/Wellcare Product Product (Auth required for CT/CTA, MRI/MRA, NUCMED, OB Ultrasound)
• HealthFirst (Auth & Out of Network Benefits)
• Heritage/Summitt/Workers Comp (Auth required for everything)
• Humana PPO/HMO HMO (Auth must be verified)
• Humana/MD Medicare (Auth required for CT, MRI/MRA, NUCMED STRESS)

Itop

• IHP
• Interplan (IHG)/formally Accountable Health Plan (AHP)
• Independent Health/PHCS/Medicare Replacement/Referring physician must call insurance regarding all exams
• Insurers Administration Corp/PHCS (Auth required for CT, MRI/MRA)

Ktop

• Kemper/Work Comp (Auth required for everything)

Mtop

• Magnacare/ First Health (Case to case. Or if patient has out of network benefits)
• Mailhandlers/First Health) (Auth required for CT, MRI/MRA, NUCMED STRESS)
• Medical Mutual/First Health
• Medicare
• Medicare Advantage: (Auth must be verified)
• Medishare/PHCS - Christian
• Medfocus/Workers Comp (Auth required for everything) – Provider Oaks #30580 Provider Suntree #30581
• Medlink/All Rad/Workers Comp (Auth required for everything)
• MedPlus
• Medrisk
• Mega Life and Health Ins company/Beechstreet
• MVP-Health Plans (Auth required for CT, MRI, NUCMED)
• Meritain Health/PHCS (Auth required for everything)
• Multiplan
• MyMatrixx/Homelink

Ntop

• NALC (Auth required for CT/CTA, MRI/MRA, NUCMED through Care Allies)
• National Preferred Provider Network (NPPN)
• NextImage Medical
• NPPN/AIG Companies

Otop

• One Call/Work Comp (Auth required for everything) – Oaks Provider #FL295 Suntree Provider #FLD9J
• Opticomp/Workers Comp (Auth required for everything)
• Optimum Health/Medicare Replacement Replacement (Auth required for MRA,NUCMED)
• Optum
• Orchid Medical/Workers Comp (Auth required for everything)
• Oxford/Unitedhealthcare (Auth must be verified)

Ptop

• Pacificsource Health Plan/First Health
• PHCS
• PHN
• PCIP/GEHA/FIRST HEALTH (Auth required through Medsolutions)-pre-existing insurance through Geha
• Preferred Care/PFFS (Medicare Replacement)
• POMCO (Auth required for CT, MRI/MRA, NUCMED EXAMS)
• Prime
• ProAmerica/Multiplan

Stop

• SAG-Producers Health
• Samba Health Benefit Plan (Cigna)
• Sedgewick/Workers Comp (Auth required for everything)
• Secure Horizons Network (Auth required for CT, MRI/MRA, NUCMED)
• Secure Horizons/United Healthcare (Auth required for CT, MRI/MRA, NUCMED)
• Seminole Tribe of Florida (Intetico) uses First Health or Multiplan as network.
• Southcare (Medicare Suppliment thru Coventry)
• Spreemo Workers Comp (Auth required for everything)
• Starbridge Choices/Beech Street/Cigna Bridge Network (Auth must be verified)
• Staywell HMO/Wellcare Product (Auth required for CT/CTA, MRI/MRA, NUCMED, OB Ultrasound)
• Sterling Option/ Medicare Advantage Program
• Streamline Imaging/Workers Comp (Auth required for everything)
• Summit Healthplans/NIA
• Summitt/One Call/Workers Comp (Auth required for everything)

Ttop

• TechHealth/workers comp (Auth required for everything)
• Three Rivers Provider Network (Auth required for CT/CTA, MRI/MRA, NUCMED, ECHO, STRESS ECHO)
• Today’s Options: Medicare advantage insurance (Out of Network Benefits)
• Total Network Resources
• Travelers/Workers Comp (Auth required for everything)
• Tricare – Active Duty (Auth required for everything)
• Tricare Prime (Auth required for MRI/MRA)
• Tricare Standard and Select

Utop

• Unicare of Commonwealth Service Center (Auth required for CT, MRI/MRA)
• United American
• Unicare (CCN) (Auth required for CT, MRI/MRA, NUCMED)
• United Healthcare (Auth required for CT, MRI/MRA, NUCMED)
• Unity/PHCS- the PPO and POS plans. (NON PAR with their HMO)
• United Healthcare/Definity Health/APWU APWU (Auth required for CT, MRI/MRA, NUCMED)
• United HealthCare Dual Complete (Medicare/Medicaid combo) (Auth required for ALL High-tech exams)
• United Healthcare/Empire (Auth required for MRI/MRA)
• US Imaging (US Imaging must scheduled in order to be billed through them for discount)
• USA Managed Care – Provider #1136401
• USIS/Workers Comp (Auth required for everything)

Vtop

• VGM / HomeLink
• Vista Health Plans/Coventry/NIA (Medicare Advantage)

Wtop

• Wellcare/Medicare –Prov#216340 (Auth required for CT/CTA, MRI/MRA, NUCMED, ECHO, STRESS ECHO, OB Ultrasound)