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Pre-Auth required: call number on card PFP, PEB, PEBTF plans MRI ...
www.ImagingCenterofLancaster.com INSURANCE CARRIERS PRIOR AUTHORIZATIONS ANDREFERRALS AETNA Healthplans *Call Aetna @ 1.800.624.0756 Pre-Auth required:
Prior Authorization Request Form Prior Authorization (General)
bravo health prior auth
Humana Prior Auth INSURANCE CARRIERS PRIOR AUTHORIZATIONS AND REFERRALS
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www.imagingcenteroflancaster.com INSURANCE CARRIERS PRIOR AUTHORIZATIONS AND REFERRALS AETNA Healthplans *Call Aetna @ 1.800.624.0756
Fax back to: 866-464-0709 For info call: 877-813-5595 For additional Prior Authorization forms, go to http://www.bravohealth.com/providers.aspx
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