Pre-Certification
- Pre-Certification is required for most MRI and CT Scans.
- Allow 2-3 business days to obtain and verify pre-certification.
- Emergency pre-certifications can sometimes be obtained within 3 hours.
- Some insurance plans may require the patient to call their change site line to choose Montclair Radiology.
- Insurance Plans may attempt to assign a radiology facility to the patient. The patient has the right to choose Montclair Radiology.
- Horizon NJ Health requires notes and a minimum of 5 days
Montclair Radiology’s Billing and PreCertification department can be reached at 973-284-0020 (option 2) or by e-mail at precert@montrad.net.
Same day, evening & weekend appointments available. Complimentary transportation for MRI & CT Scans offered upon request.
Call 973-661-4674 today to schedule an appointment
Participating Insurances
View Participating Insurance Providers as a Text List
- Aetna (excluding Northern NJ Prime HMO)
- Aetna Better Health & Dual Complete
- Atlantic Imaging Group – AIG
- Amerigroup
- AmeriHealth
- Atlantic Health (Qualcare)
- Beech Street
- Consumer Health Network – CHN
- Cigna
- Clover Health (Medicare)
- Coventry
- Department of Veteran Affairs
- Devon
- Empire BCBS (only local network)
- Essex County Workers Comp
- First Health
- Government Employee Health Assoc. – GEHA
- GHI/Emblem Health (PPO ONLY)
- Great West
- Health Network America
- HealthNet Veterans Choice
- HIP (PPO ONLY through Qualcare)
- Horizon Blue Cross Blue Shield of NJ (Tier 1)
- Horizon NJ Health and TotalCare
- Humana/Choice Care (Qualcare) excluding Medicare
- Local 825
- Liberty Healthshare
- Mail Handlers
- Magnacare
- Medicare
- Multi Plan Network
- New Jersey Manufacturers
- OccuNet
- One Call Medical
- OSCAR (Qualcare)
- Oxford
- Prime Health Services
- Private Healthcare Systems (PHCS)
- Qualcare (all plans) (Tier 1)
- United Healthcare (excluding Medicare Focus)
- United Healthcare Community Plan of NJ ONLY
- Wellcare
- WTCHP-World Trade Center Health Plan
Essex County Workers Comp.
DO YOU KNOW WHAT YOUR INSURANCE COST SHARE IS?
DO YOU KNOW WHAT YOUR INSURANCE OUT-OF-POCKET COSTS ARE?
DEDUCTIBLE
The amount you must pay for covered healthcare services before your health insurance kicks in.
Example: If Luke’s deductible is $2,000 his insurance won’t pay for anything until he has paid $2,000 for covered health care costs. If he requires hospitalization that costs $3,000, he would pay the $2,000 deductible, and the plan would pay for a portion of the remaining $1,000 (based on Luke’s plan specifics).
COINSURANCE
The percentage of the bill you pay for a covered product or service.
Example: Let’s sayTony visits his in-network doctor when he’s ill. He has already met his deductible, and his plan now requires a 20 percent coinsurance The cost of his insurance plan’s contracted rate is $150, he owes $30. His insurance company will pay the rest.
COPAYMENT
Set dollar amount you pay for a covered product or service.
Example: Sara has a $20 copay for visits with her primary care physician (PCP) and a $40 copay for urgent care visits. What does that mean? She will pay $20 for every doctor visit and $40 every time she goes to urgent care.
Most insurance plans require patient OUT-OF-POCKET costs for deductible, coinsurance and/or copayment.
Patients will be billed for all OUT-OF-POCKET costs after your insurance company has processed your claim.
Your insurance plan is a contract between you and your insurance company. If you want to know your coverage, please contact your insurance company.
SCREENING MAMMOGRAPHY – If criteria is met, there will be NO out-of-pocket cost
SCREENING BONE DENSITY – If criteria is met, there will be NO out-of-pocket cost
SCREENING BREAST ULTRASOUNDS – Out-of-pocket cost will be decided by your insurance company
