Insurance Information
Irvington Radiologists, P.C. is an approved provider for many insurance carriers. We will submit your claim
(primary and secondary) to any insurance company under the benefit coverage you specify.
DISCLAIMER: Irvington Radiologists, P.C. participates with many medical groups to provide healthcare service
to their HMO members and participates with numerous other PPO healthcare plans. Please check with your
individual medical group, IPA or provider directory to verify plan and benefit coverage. Do not rely on this
page to make a medical referral decision.
We are in-network with the following companies (not an all-inclusive list):
- Advantage Health Solutions/Advantage Preferred Plus
- Aetna
- Anthem
- Beech Street
- Champus/Tricare
- Community Care Network (CCN)
- Cigna
- Encircle
- Encore Health Network
- Great West Healthcare (Cigna)
- Hancock Regional PHO
- HealthChoice PPO
- Humana
- Indiana Health Network (IHN)
- Medicaid (and some Medicaid HMO’s)
- Medicare
- Medicare Advantage
- Advantage 360
- Advantange Preferred
- Advantange Preferred Plus PPO
- ChoiceCare
- Clarian Medicare Advantage
- Humana Choice PPO
- Humana Medicare HMO
- Todays Options
- Wellcare
- National Provider Network (NPPN)
- PPO Next
- Preferred Plan of Indiana
- Prudential
- ProHealth Network (Including Healthmark)
- Sagamore Plus
- Suburban Health Organization
- United Healthcare
Ultimately, you are responsible for payment of your account, including any balance not covered by insurance.
You will receive a statement indicating any patient responsibility amounts due. Payment is due upon receipt of
the statement unless other arrangements are made with Irvington Radiologists, P.C. We accept payments by check,
Visa, and Mastercard.
Common Insurance Terminology
I have received two bills for the same test. Am I being double billed?
No. For any radiology service, there are two (2) components; the technical component for performing the imaging
service and the professional component for interpreting the results. The bill you will receive from the hospital
is for the technical component. The bill you receive from Irvington Radiologists, P.C. is for the interpretation.
Why am I getting a bill from a doctor whom I have never met?
The doctor on Irvington Radiologists’ bill is a specialist in radiology. The majority of the time, the
Radiologist does not meet face-to-face with the patient. The Radiologist has interpreted the imaging service and
will report the results to the patient’s ordering provider.
I gave my insurance information at the hospital. Why am I getting a bill?
Irvington Radiologists uses patient demographic and insurance information provided by the hospital. The majority
of the time, the information provided is accurate and up-to-date; however, sometimes the information provided is
incorrect, incomplete or missing. In this instance, we rely on your cooperation in providing us your complete and
correct insurance information.
How can I get the results of my tests?
Our office has billing records only. For the results of any test you may have done, you should contact the office
of the physician who ordered the test. They should have a copy of the report from the Radiologist.
Common Insurance Terminology
Allowable:
When a healthcare provider agrees to participate in a specific insurance plan, they agree to accept as payment in
full the amount the insurance designated as the “allowable� reimbursement amount for a given service. The difference
between the actual charge and the insurance company’s allowable is considered a contractual amount that must be
written off. Some insurance plans pay only a portion of the allowable. The payment amounts from your insurance
company will depend on what co-payments, co-insurance, or deductible you may be required to pay.
Co-Payment:
Your insurance plan may have set amounts you are responsible to pay for specific services. Co-payments are most
commonly associated with office visits, hospital emergency room or urgent care visits, and prescription drugs.
Although not as common, some plans do set co-payments for radiology services.
Co-Insurance:
Your insurance plan may only pay a portion of the allowable reimbursement. The remaining co-insurance amount is
your responsibility to pay. The amount will depend on your insurance benefit. For example, if the allowable for
a service is $100.00, and your insurance pays 70% ($70.00), your co-insurance would be $30.00.
Deductible:
Your insurance plan may require you to pay for a specific dollar amount of health care services per year before
they begin to pay your medical bills. This amount, the deductible, will depend on your insurance company and your
specific benefit plan. For example, if the allowable for a service is $100.00, your deductible is $100, and you
have not yet paid any medical bills this plan year, you would be responsible for the entire $100.00.
