|
Insurance Name |
Hospital Service |
Referral Form Required |
Pre-Certification Phone Reference |
Initiating Provider |
|
Aetna US Healthcare Aetna US Healthcare
Medicare |
Inpatient
Acute
Care – Elective
Non-Elective Extended
Acute |
Yes No No |
Yes Yes Yes |
Admitting Physician |
|
Billing
Address: |
Skilled
Nursing Facility |
No |
Yes |
Admitting Physician |
|
|
Outpatient
|
|
|
|
|
PO
Box 1125 |
Emergency Room Visits |
No |
No |
|
|
Blue
Bell, Pa. 19422 |
Same
Day Surgery |
Yes |
Yes |
PCP/Specialist |
|
|
Diagnostic
Radiology |
Yes |
No |
PCP |
|
Eligibility 800-245-1206 |
CT Scan |
Yes |
No |
PCP |
|
|
Stress Test |
Yes |
No |
PCP |
|
Pre-Certification 610-283-6850 |
Nuclear Stress Test |
Yes |
No |
PCP |
|
|
Echo |
Yes |
No |
PCP |
|
Provider
Services 800-245-1206 |
Ultrasound |
Yes |
No |
PCP |
|
|
Chemotherapy |
Yes |
Yes |
PCP |
|
|
Laboratory |
|
|
|
|
|
Capitated with SmithKline |
Yes –SmithKline Lab Form |
No |
|
|
|
STAT testing at Hospital |
Yes – Write stat on form |
No |
|
|
|
Pre-Admission Testing |
Yes – See note #1 |
|
PCP/Specialist |
|
Referral
is good for 90 days |
Cardiology Department |
Yes
|
Yes |
PCP |
|
Unlimited
visits per referral |
Physical
Therapy |
Yes |
Yes |
PCP |
|
|
Speech
Therapy |
Yes |
Yes |
PCP |
|
Contact
Person: |
Occupational
Therapy |
Yes |
Yes |
PCP |
|
Don
Fox |
Pulmonary/Respiratory |
Yes |
Yes |
PCP |
|
610-251-6362 |
Gastroenterology |
Yes |
Yes |
PCP |
|
|
Infusion |
Yes |
Yes |
PCP |
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