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Tax ID: 72-1503733 & NPI#: 1942336243

PLAN / PHONE NUMBER

AARP / 800-227-7789 ABRAZO ADVANTAGE PLUS / 602-824-3900 (Medicare Replacement) ACCOUNTABLE HEALTH - PPO / # ON CARD ADMAR - PPO / # ON CARD ADMINISTRATIVE ENTERPRISES / 602-789-0780 ADNET / 623-876-1860 AETNA

NOTES

Medicare supplement follows medicare guidelines Auth required for MRI/MRA, CT, PET Auth requirements varies by payer; call to verify Auth for varies by payer; call to verify Auth thru American Health Group Auth req. HMO - Call 800-624-0756 ; PPO - Call 888-632-3862(Benefits). Auth varies by plan thru MedSolutions. Call to verify No auth required Auth required for MRI/MRA,PET(Except when PT has APIPA Personal Care Plus Primary) ONLY ORDERING DOC CAN OBTAIN AUTH No authorization required Auth varies; call to verify. Thru Medsolutions Auth varies; call to verify-Call number on ID card Authorization varies by employer, call to verify No auth required Auth varies; call to verify. Thru American Health Group Auth varies; call to verify. No auth req except for XBH,can obtain by phone. Auth varies; call to verify Auth required for CT, MRI/MRA, PET, and DEXA Scans No authorization required Authorization through NIA / Varies by plan / 866-214-7103 Auth varies; call to verify. Auth varies; call to verify. Auth required for all procedures over $250 Auth varies; call to verify. Auth varies by payer, call to verify Auth varies; call to verify. Auth varies; call to verify. Auth varies, call to verify. Thru MedSolutions No auth required Auth varies, call to verify. Thru MedSolutions

AETNA CHICKERING GROUP / 800-927-0783 AMERIBEN / 800-786-7930

APIPA / 800-348-4058 (AHCCCS) APIPA PERSONAL CARE PLUS / 877-614-0621(Medicare Replacement) APWU / 800-222-2798 ARIZONA FOUNDATION FOR MEDICAL CARE ARIZONA MEDICAL NETWORK (AMN/HMN) PPO BANNER CHOICE PLUS / 480-827-7070 BASHA'S / 602-275-8744 BEECHSTREET / 866-333-4648 BLUE CROSS / BLUE SHIELD OF ARIZONA / 602-864-4400 BLUE CROSS / BLUE SHIELD(OUT OF STATE)/800-676-2583 CARE 1ST (AHCCCS)/HEALTH CARE GROUP / 602-778-1800 CARE 1ST ADVANTAGE PLAN / 602-778-1800 (Medicare Replacement) CIGNA HEALTH CARE / 800-244-6224 CITY OF MESA / 480-644-2299 DEFINITY HEALTH / 866-333-4648 DES - CMDP / 602-351-2245 EVERCARE / 800-293-3740 FIRST HEALTH / 800-742-1533 FORTIS HEALTH / 800-553-4654 GALLAGHER BENEFIT / 866-761-6280 GEHA / 800-821-6136 GOLDEN RULE / 317-297-4149 GREAT-WEST HEALTHCARE / 800-663-8081

Central Scheduling

Prior Authorization

Phone: 4807679008 Phone: 4807679008 x115 Fax: 4807679035 Fax: 4807672449 Arrowhead Chandler Palm Valley Scottsdale Tempe

HEALTH CHOICE (AHCCCS) / 480-968-6866 HEALTH CHOICE GENERATIONS /489-968-6866 (Medicare Replacement) HEALTHNET OF ARIZONA - Not contracted with the BPHO network 800-289-2818 HUMANA / 800-558-4444 INDUSTRIAL COMMISSION / 602-542-4661 LIFEWISE AZ / 800-592-6795 LIFEWISE OREGON / 800-611-4947 MAIL HANDLERS / 800-410-7778 MARICOPA HEALTH PLAN(AHCCCS) / 602-344-8760 MAYO / 800-335-6296 MED FOCUS / 800-782-7666 MED-FIN MANAGER MEDICARE / 877-908-8431 or 800-933-0614 MEDICARE RAILROAD / 877-288-7600 MERCY CARE ADVANTAGE / 602-230-9921 MERCY CARE PLAN (AHCCCS) / 602-230-9921 MERCY HEALTHCARE GROUP / 602-265-0144 MMSI (formally Mayo Health Plan) MOUNTAIN STATES / 800-866-4731 MUTUAL OF OHAHA / 800-789-9770 NATIONAL CHOICE CARE - WRKMN'S COMP ONE CALL MEDICAL ONE CARE (AHCCCS-MEDICARE REPLACEMENT) 602-778-1800 PACIFICARE / SECURE HORIZONS / 800-283-7525 PHCS - PRIVATE HEALTHCARE PPO PHOENIX HEALTH PLAN (AHCCCS) / 602-824-3760 PPO NEXT SCAN LTC / BRIDGEWAY / 888-540-7226 SOUTHWEST SERVICE ADMINISTRATORS / 602-249-3582 STATE COMPENSATION FUND - WRKMN'S COMP TRICARE / 888-874-9378 TRICARE CHAMPVA TRICARE FOR LIFE / 866-773-0404 UNITED HEALTH CARE / 877-842-3210 UNIVERSITY FAMILY CARE (AHCCCS) / 602-344-8760 ZENITH ADMINISTRATORS / 602-248-8434

Auth required for MRI/MRA, 2nd and subsequent OB ultrasounds, DEXA under age 50, PET Auth required for MRI/MRA, 2nd and subsequent OB ultrasounds, DEXA under age 50, PET Authorizations required for CT, MRI/MRA, PET , Muga through MedSolutions Auth thru NIA. Auth varies, call to verify Auth varies; call to verify. Auth varies; call to verify. Auth varies; call to verify. No authorization required Auth req for MRI/MRA, PET Auth varies; call to verify. Auth varies; call to verify. MedFin must approve (Contact Central Scheduling) No authorization required No authorization required Auth for MRI/MRA and PET Auth for MRI/MRA and PET Auth Required for MRI, MRA, and PET Prior authorization requirements vary by payer, call MMSI to verify No auth required Auth varies; call to verify. Call NCC to schedule OCM will call and schedule Auth required for CT, MRI/MRA, PET, and DEXA Scans Auth varies, call to verify. Not contracted with East Valley Network Auth varies, call to verify Auth required for CT,MRI/MRA ,PET-ABRAZO is Preferred Provider Authorization varies by payer, call to verify Auth varies; call to verify. No auth required Call to verify auth with adjuster. Auth varies; call to verify Authorization varies; call to verify No authorization required,follows medicare guidelines Medicare is primary, TRICARE is secondary Auth varies; call to verify. ONLY ORDERING DOC CAN OBTAIN AUTH Auth req for MRI/MRA, PET No auth required

Physician Services Representatives

East Valley (Tempe, Mesa) & Metro Phoenix East Valley (Chandler, Gilbert) Scottsdale West Valley 6233305058 4806206342 4805864754 6027055591

Arrowhead Chandler Palm Valley Scottsdale Tempe

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