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Locations & Hours | Radiology Services & Procedures | Insurance Info | Policies & Payments
Commercial Insurance
Your radiologist is a member of most network organizations. If you have a
question about our participation in your plan, please call our billing office
for confirmation. We will file your insurance as a courtesy to you, but the
final resolution and payment of the bill is your responsibility. Our
relationship is with you, not your insurance company, but our staff will help
you ensure that your insurance carrier complies with the terms of your plan.
Please be aware that some insurance plans require referrals and
pre-authorizations for selected imaging studies. Talk with your primary care
physician or ordering physician if you feel your plan requires these steps. You
may also consult your employer group health insurance booklet or your company’s
human resources department.
Medicare
Our physicians are participating providers with Medicare and we will file your
Medicare claims for you. We accept assignment of benefits on all Medicare
claims. Medicare will send payments and an Explanation of Medicare Benefits
(EOMB) directly to our office. An EOMB will also be sent to you from Medicare.
Medicare will pay 80% of their approved amount. The remaining 20% of the
Medicare approved amount and any deductibles are your responsibility. If you
have supplementary coverage to Medicare, we will file the necessary claims for
that coverage as well. However, if your secondary insurance does not pay the
portion left after the Medicare payment, you will be responsible for paying the
remaining balance. A billing statement will be sent to you showing the balance
payable after the Medicare payment is received.
Medicaid, TennCare, and other federally funded plans
We participate with Champus, Medicaid and certain TennCare providers. Please
call our office or your TennCare carrier for confirmation of our participation
if you have questions. Our office staff will file Champus, Medicaid and
TennCare claim forms. If a balance is due after the plan’s payment is received,
you will be sent a billing statement indicating this activity.
Usual, Customary and Reasonable Charges
Many health insurance plans pay using a percentage of Usual, Customary and
Reasonable (UCR) charges. Our fees are competitive and generally are within the
UCR range for our area. However, some plans pay a set fee from an arbitrary
schedule or list of fees for each service. These fees may bear no relationship
to the current cost of care. We do not discount fees due to UCR, but our
billing staff will assist you if your plan applies a UCR rate that falls below
our fees. We can produce documents for your insurance carrier showing the
actual cost of care in our area. Should your insurance choose to pay below our
fees due to their UCR, the remaining balance will be your responsibility.
Please consult your employer’s group health insurance booklet, your employer’s
personnel department, or your insurance company if you have coverage questions.
Insurance List
Following is a general list of insurance companies in which Radiology Alliance
participates. The list is being continuously updated so to verify your coverage
or to find out more detailed information, please contact your insurance company
directly at the number listed on the back of your insurance member ID card.
This list does not guarantee coverage or participation.
Aetna
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Beech Street
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Blue Cross (All Products)
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BlueCare
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CIGNA Healthplans
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Community PPO of Middle Tennessee
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First Health
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Health Spring
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Humana Choice Care
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Humana Tricare
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Medicare
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Signature Health Alliance
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TennCare
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TennCare Select
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United Health Care
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