Health Insurance / Current Providers

Most insurance providers accepted. Your insurance provider not listed? Contact us to find out if we accept yours at (805) 286-4617

Aetna
AIG Claim Service
AARP
Bakersfield Family Medical HMO
Bankers Life
Blue Cross
Blue Shield
CCN
Cencal
Cigna
Coastal Community Physician Network

Delta
Great West
Health Net
Health Net Pearl
Health Systems (CMSP)
Humana
IBEW
InterplanLaborer’s Health & Welfare
Medi-Cal
Medicare
Operating Engineers

Pacificare Physicians Choice:
Accepted at RDC for X-ray ONLY.
Accepted at DMI for Open MRI and
PET with Authorization ONLY.
Pipe Traders
Principal Life
Santa Barbara Health
SecureCare Medicare
SouthWest Administrators
Tri Care
UFCW
United Healthcare
Wellcare
Western Growers

Common Insurance Questions

I have Medicare, Part A & B. will you bill my insurance for me?
As a courtesy, Radiology Associates will bill your insurance company for your services provided today. You are responsible for providing the correct and most current insurance information. You may be liable for any services you receive if you fail to provide the correct insurance information in a timely manner.

I have Medicare, Part A & B, do I need authorization for my radiology services?
Medicare does not require authorization for your radiology services, which are covered by Medicare Part B.

What is an ABN and why do you ask Medicare patients to sign it?
An ABN is an Advanced Beneficiary Notice of NonCoverage. It advises you that Medicare may not pay for the service you are receiving today. If Medicare doesn’t pay, you agree to pay a reduced fee for this service you are receiving today.

Do I need an authorization for my radiology services?
Medicare does not require authorization for your radiology services. All other insurance carriers will usually require an authorization for CT Scans, MRI’s, MRA’s, PET Scans and Nuclear Medicine. Because each insurance carrier has different requirements, based on your policy or plan, we encourage you to contact the telephone # on the back of your insurance ID card for more information about authorization for your medical care, prior to receiving the services.

I have PPO or HMO coverage, will you bill my insurance for me?
As a courtesy, Radiology Associates will bill your insurance company for your services provided today. You are responsible for providing the correct and most current insurance information. You may be liable for any services you receive if you fail to provide the correct insurance information in a timely manner.

I have PPO or HMO coverage, do I need authorization for my radiology services?
Most PPO and HMO insurance carriers require authorization for CT Scans, MRI’s, MRA’s, PET or Nuclear Medicine.

If I need an authorization, how do I get it?
The MD that is ordering your radiology test should contact your insurance carrier to request the authorization for your services.

I had an authorization for my services, but my insurance didn’t pay, why not?
Your insurance carrier states that authorization is not a guarantee of payment. Payment is determined based on your eligibility, your benefits, satisfaction of your deductible, co-payment or co-insurance as well the insurance company’s determination of medical necessity of the test.

What is a deductible?
A deductible is the amount you must pay out of pocket (annually) before your insurance will begin paying.

What is a co-payment?
A co-payment is a fixed dollar amount that you will pay per visit, based on the type of service and / or location of the service (This information is usually indicated on your insurance ID card).

What is a co-insurance?
Co-insurance is based on a percentage of the amount your insurance company will allow for the radiology services you receive today. Example: 80/20 means your insurance company will pay 80% of what they allow, you will pay 20% of what your insurance will allow. 70/30% means your insurance company will pay 70% of what they allow, you will pay 30% of what your insurance will allow, etc.

How can I have a deductible and a co-payment or co-insurance?
Your deductibles must be paid annually, your co-payment or co-insurance is due based on each date of service. If you haven’t satisfied your annual deductible, you may be responsible for both the annual deductible and a co-payment or co-insurance.

Collection Agency Information

Patients seen on or after April 12, 2010:
If your account was sent to Collections, please make all inquiries and payments by logging onto CMRE’s website below:
www.cmrefsi.com

or by calling: (800) 783-9118

Patients seen prior to April 12, 2010:
If your account was sent to Collections, please make all payments and inquires directly to the address below:

Grant Mercantile Agency
PO Box 658
Oakhurst, CA 93644
Phone 800-821-7530
Fax 559-658-8968