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.
- Wake Radiology now 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.
|Download our managed care list|
|MANAGED CARE PLANS|
|Aetna||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 Options, Blue Select & Blue Options||Not part of the Blue Local network.|
|North Carolina State Health Plan (administered by BCBSNC)|
|BlueCross BlueShield in states outside of North Carolina|
|Cigna HealthCare (see also GW Cigna)||Not part of the Cigna Connect network. Members in this network do not have out-of-network- benefits.|
|Coventry Health Care of the Carolinas (formerly WellPath)|
|GW Cigna (formerly Great West Healthcare)|
|NON-PAYOR NETWORK PROGRAMS & PPOS|
|Healthgram (formerly Primary PhysicianCare)|
|Three Rivers Provider Network (TRPN)|
|MILITARY / GOVERNMENT PLANS|
|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.|
|MEDICARE / MEDICAID|
|Medicare Part B|
|Medicaid of North Carolina|
|MEDICARE PART B SUPPLEMENT PLANS|
|All Medicare Part B supplement plans accepted|
|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.|
|United Healthcare Medicare Solutions for NC state government retirees only||NC state government retirees with United Healthcare Medicare have in-network benefits at Wake Radiology because the state negotiated a special arrangement for patients who switch from BCBS to United Healthcare Medicare plan. The carrier has agreed to treat in-network and out-of-network providers the same way with no financial penalty to the patient.|