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General Information

Many insurance companies require a referral and/or pre-certification (especially for CT and MRI), it is the responsibility of the patient and referring physician to obtain approval in advance in writing. Failure to obtain the required information may result in non-reimbursement or delay in treatment.

Listed below are the larger insurance companies and the third party review companies that handle their pre-certifications:

CareCore National handles pre-certification for:

  • Aetna 888-647-5940
    Scheduling Line 800-792-8793
    (Aetna requires the patient to call the scheduling line to choose Montclair Radiology in addition to pre-cert)
  • Horizon BC of NJ 866-496-6200
    Scheduling Line 866-969-1234
    (Horizon requires the patient to call the scheduling line to choose Montclair Radiology in addition to pre-cert)
  • Oxford 877-773-2884
    Scheduling Line 800-933-7618
    (Oxford requires the patient to call the scheduling line to choose Montclair Radiology in addition to pre-cert)
  • Healthnet 866-469-8989
    Scheduling Line 866-699-8131
  • United Healthcare 800-818-8307

CareCore will attempt to assign a radiology center, however the patient has the right to choose Montclair Radiology.

Pre-certification and eligibility can be verified on the CareCore website: CareCoreNational.com CareCore's fax number to send clinical information for all the above plans: 845-298-1490

American Imaging handles pre-certification for:

  • Cigna (HMO) 800-859-5288
    AmericanImaging.net
  • AmeriHealth (NJ) 800-859-5288
    Some Independence BCBS

MedSolutions handles pre-certification for:

Please Note: Allow a minimum of 2 business days for all pre-certifications. Emergency pre-certs can sometimes be obtained by the referring physician within 3 hours if medically necessary. Additional clinical information may be required for some MRI & CT. Each time additional clinical information is required by the pre-cert company, the pre-cert will be delayed an additional 2 days from the time they receive the information.

Montclair Radiology may accommodate patients on an individual basis who participate in any managed care organization not listed above. Please contact our billing office at 973-284-0020 or email billing@montclairradiology.com with any questions.

Participating Health Plans

  • AETNA
  • AmeriHealth
  • Beech Street
  • CHN (Consumer Health Network)
  • CIGNA HealthCare of Northern NJ
  • CIGNA Healthsource
  • CIGNA Co-Med HMO
  • Core Source
  • Cost Care
  • Devon
  • Essex County Workers Comp
  • First Health
  • GEHA (Government Employee Health Assoc.)
  • Health Network America
  • Healthnet
  • Horizon Blue Cross Blue Shield of NJ
  • Humana/Choice Care
  • InterGroup
  • International Union of Operating Engineers
  • Medicare
  • Multiplan Network
  • New Jersey Manufacturers
  • One Call medical
  • One Health Plan
  • Oxford Health Plans
  • PHCS (Private Healthcare System)
  • QualCare
  • United Healthcare