Some medical procedures require pre-authorization from your insurance company. We will assist your doctor’s office in obtaining pre-authorization as needed. Insurance carriers who require preauthorization for imaging procedures require that your doctor provide the insurance company with some clinical information concerning your medical condition and, sometimes, prior treatments. If your plan is not listed below as a Participating Health Plan, it is your responsibility to get preauthorization, not your doctor. A partial list of common procedures requiring preauthorization can be found below.
Please work with your doctor and insurance company to ensure your preauthorization, when required, is received by Jefferson Radiology before your scheduled exam.
Without your insurance carrier’s preauthorization number you may become fully financially responsible for any services rendered or your appointment time may need to be rescheduled. Our Preauthorization Department can be reached at 860-289-3375 from 8:30 AM until 5:00 PM Monday through Friday to assist you and your doctor’s office.
Imaging exams usually requiring preauthorization are, but not limited to:
- CT scans (all diagnostic exams)
- MRI/MRA (all examinations)
- Nuclear Cardiology
- Bone Densitometry Tests
Jefferson Radiology will assist you in resolving your insurance questions with regard to our services. If necessary, our billing team can establish a payment plan to help you meet your financial responsibility.
Diagnostic Imaging Billing Practices
Unlike other imaging centers, Jefferson Radiology offers both facility and reading services. This means that your visit includes both the administration of your imaging exam and the interpretation of your images by one of our radiologists. Depending on where your imaging exam is performed, you may receive two separate billing statements:
Global Billing: Under global billing, patients will receive a single bill with the total of their final costs. The statement includes both the taking and reading of images. An exam performed at any of Jefferson Radiology’s nine imaging centers falls under this category.
Professional Billing: Under professional billing, patients will receive two separate statements that together will amount to the final cost of their visit. This is because Jefferson Radiology oversees ONLY the reading of images. For example, when you visit one of Jefferson Radiology’s affiliated hospitals, you will receive one billing statement from us for the reading of your images and you will receive a separate billing statement from the affiliated hospital for the taking of your images.
Participating Health Plans
- Aetna HMO/MC/PPO/EPO
- Aetna Better Health
- Aetna Focus – Workers Comp
- Anthem Blue Cross/Blue Shield of Connecticut
- Anthem Blue Cross/Blue Shield MediBlue (Medicare Advantage HMO & PPO)
- Americhoice – Medicaid
- Benesight PPO (TPA of CT)
- Berkley Administrators of Connecticut
- Blue Cross/Blue Shield Federal
- Blue Cross/Blue Shield National
- Care IQ (Workers Comp Network)
- Champus (Tricare / Va)
- Cigna Healthcare of Connecticut
- Cigna/Healthsource of Connecticut
- Community Health Network – Medicaid (Saga & Charter Oak Plan)
- Department of Labor/Energy
- First Health-Husky A&B Medicaid Only (Covers Children Only)
- Great–West Healthcare (One Health Plan)
- Health Management Center (HMO/PPO)
- Health Net of Connecticut – CT Access Medicaid, Smartchoice Medicare (PHS)
- Health New England – (Select Plans Only)
- Massachusetts Medicaid
- Mashantucket Pequot Tribe (through Multiplan)
- Medicaid-State & City (Welfare)
- New York Medicaid
- North East Health Direct (NEHD)
- Ohio Bureau of Workers Comp
- One Call Medical (OCM-WComp Network & US Group Health)
- Oxford Health Plan (Including Medicare Advantage)
- Private Healthcare Systems (PHCS)
- Railroad Medicare
- Tech Health (Workers Comp Network)
- United Health Care – PPO/POS/EPO/Choice/Evercare
- US Imaging Network
- Wellcare (Perferred One/First Choice)
Note: Participation subject to change at any time.