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Insurance Plans & Resources

Wake Radiology is a contracted, in-network provider for most major managed care insurance plans. Today, the majority of insurance plans pass a portion of their cost of care to patients, in the form of a deductible and/or co-insurance.

For patients whose plans are not within our managed care network, we can still provide imaging services as well as file claims on their behalf. It’s important to note that most of these insurance plans (including UnitedHealthcare) do have out-of-network benefits that cover Wake Radiology imaging fees. However, these out-of-network services may result in a higher cost share to the patient.

We recommend patients talk with their insurance carrier about our network status and their anticipated cost of care with us. Patients may be able to reduce their net out-of-pocket cost by using Wake Radiology’s prompt-pay discount. This allows patients to pay at the time-of-service and receive reimbursement once their insurance carrier pays the claim.

Recent News

  • Wake Radiology is an in-network provider with United Healthcare. Wake Radiology accepts and files United Healthcare and UHC Medicare replacement plan for patients as an in-network provider. Our UHC contract allow us to extend our commitment to excellence  in medical imaging throughout the region.
  • Wake Radiology accepts TRICARE military coverage for all clinical services. Previously, Wake Radiology accepted TRICARE for only breast-related imaging. As of February 1, 2012, we accept and file TRICARE plans – both primary and secondary – for all radiology services.
  • Wake Radiology accepts workers’ compensation cases and files claims to all carriers. We accept workers’ compensation cases, file claims to all carriers and honor the North Carolina Industrial Commission (NCIC) fee schedule for workers’ compensation. Although we do not participate with workers’ compensation brokering/3rd party networks (e.g., OneCall Medical, Corvel and DiaTri), most workers’ compensation insurance carriers authorize imaging services when Wake Radiology is a referring provider’s preference. Of note, we interact with workers’ compensation carriers to confirm NCIC rates and obtain authorization for service.

Wake Radiology Managed Care List

icon-download-gray  Download our managed care list

 

Managed Care Plans
  • Aetna / Aetna Conventry: Not part of the Duke Select and Duke Basic Network. Members in these networks do not have out-of-network benefits.
  • BlueCross BlueShield of North Carolina (BCBSNC) including but not limited to: Blue Advantage, Blue Care, Blue Options, Blue Select, Blue Value/Blue Value with UNC HA, Classic Blue and North Carolina State Health Plan
  • BlueCross BlueShield in state, outside of North Carolina
  • Cigna Health Care / GWH-Cigna: Not part of the Cigna Connect network. Members in this network do not have out-of-network- benefits.
  • United Healthcare –
    • All Savers
    • Community Plan
    • Neighborhood Health Partnership
    • OneNet PPO
    • OptumHealth
    • Oxford Health Plans
    • UMR
    • UnitedHealthcareOne
    • United Healthcare Services Company of the River Valley
Non-Payor Network Programs & PPOS
  • Healthgram (formerly Primary PhysicianCare)
  • MedCost
  • Three Rivers Provider Network (TRPN)
Military / Government Plans
  • CHAMPVA
  • Tricare (non-Prime plans): Non-network participating provider.
  • Tricare Prime: Non-network participating provider. Member is responsible for obtaining prime referral to reduce their out-of-pocket expense.
  • Tricare for Life (secondary to Medicare): Non-network participating provider.
  • Veteran Administration (VA): Proper VA referral required.
Medicaid
  • Medicaid of North Carolina
Medicare
  • Medicare Part B
Medicare Part B Supplement Plans
  • All Medicare Part B supplements
Medicare Part C (Medicare Advantage / Replacement)
  • All Private Fee for Service (PFFS) plans accepted
  • Aetna Medicare Advantage: Not part of the Prime HMO and QHP networks. Members in these networks do not have out-of-network benefits.
  • Blue Medicare
  • First Carolina Care Insurance Company: First Medicare Direct Smart HMO & Preferred Plus, including Alignment Health
  • Humana Medicare: HMO / PPO, including Alignment Healthcare
  • United Healthcare Medicare Solutions