Aetna "Select Provider" Listing - High-Tech Radiology Toledo - January, 2012

Transcription

1 Aetna "Select Provider" Listing - High-Tech Radiology, OH Bay Park Community Memorial Hosptial* , Bay Park Drive, OH Phone: Svcs: MR, CNM, CT Mercy St. Charles Hospital* , Navarre Avenue, OH Phone: Svcs: MR, CT, PET Flower Hospital* , Harroun Road, OH Phone: Medical Imaging* , Monroe Street, Suite 7, OH Phone: Hours: M-F 8am-6pm Imaging Central, LLC* , West Central Avenue, OH Phone: / Fax: Hours: M,T,F 8am-5pm, W, Th 8am-8pm, PET Mercy St. Anne Hospital* , West Avenue, OH Phone: , , OH Svcs: MR, CT PDI, LLC* , North Holland Avenue, OH , North Holland Road, OH Svcs: OMR The Imaging , Talmadge Road, Suite H, OH Phone: / Fax: Hours: M-Sun 6am-11pm The Clinic*, OH Hours: M-F 8:15am-5pm The Hospital*, OH Hours: 24 hours/7days, CNM, CT The University of Medical, OH SENECA COUNTY Tiffin Advanced Medical Imaging* , West U.S. Hwy. 224, Suite D Tiffin, OH Phone: / Fax: Svcs: MR, CT WOOD COUNTY Bowling Green Wood County Hospital , West Wooster Street Bowling Green, OH Phone: Svcs: MR, CT, PET Note(s): These procedures may require pre-authorization. Aetna's radiology management vendors may have more current information that will supersede the information contained within this List. Effective January 1, 2012, Aetna requires all providers administering high-tech radiology services to be accredited by the American College of Radiology and/or the Intersocietal Accreditation Commission. Any provider performing these services who has not been accredited at the time of service will not be eligible for payment. Therefore, Aetna s radiology management vendors will offer alternative providers who have been determined to be accredited in accordance with these standards. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography

2 Aetna "Select Provider" Listing - Low-Tech Radiology Bay Park Community Memorial Hosptial* , Bay Park Drive, OH Phone: Flower Hospital* , Harroun Road, OH Phone: , US, M Medical Imaging* , Monroe Street, Suite 7, OH Phone: , , OH PDI, LLC* , North Holland Avenue, OH , North Holland Road, OH Ultrasound Institute & Men's Health Ctr.* , North Holland Road, Suite B, OH Phone: / Fax: Hours: M,W,Th 8am-5pm, F8am - 2pm Svcs: US The Clinic*, OH Hours: M-F 8:15am-5pm The Hospital*, OH The University of Medical, OH SANDUSKY COUNTY Bellevue The Bellevue Hospital* , West Main Street Bellevue, OH Phone: / Fax: SENECA COUNTY Tiffin Advanced Medical Imaging* , West U.S. Hwy. 224, Suite D Tiffin, OH Phone: / Fax: , FL, US, S X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography

3 ALLEN COUNTY Delphos Delphos Ambulatory Surgery , East 5th Street Delphos, OH Phone: Lima Eye Surgery Center of Western Ohio* , West Market Street Lima, OH Phone: Svcs: OPT The Endoscopy Center of West Central Ohio* , Shawnee Road Lima, OH Phone: Svcs: EN West Central Ambulatory Surgery & Endoscopy , West High Street, Suite 100 Lima, OH Phone: CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital* , North Sandusky Avenue Hours: 24/7 hours , North Sandusky Street Hours: 24/7 hours ERIE COUNTY Sandusky NovaMed Surgery Center of Sandusky, L.L.C.* , Hayes Avenue Sandusky, OH Phone: Hours: M-Th 8am - 5pm, F 8am - 4pm Aetna "Select Provider" Listing - Ambulatory Surgery HANCOCK COUNTY Findlay Findlay Surgery Center , Medical Blvd. Findlay, OH Phone: Hours: M-F 5:30am - 5pm HURON COUNTY Norwalk Podiatric Surgi-Center, INC , Executive Pkwy. Norwalk, OH Phone: Svcs: ORP , West Dussel Drive, OH Phone: , OH Surgi+Care* , Monclova Road, OH Phone: The Eye Institute of Northwestern Ohio, , Briarfield Blvd., OH Phone: / Fax: Hours: M-F 8:30am - 5pm Svcs: OPT , Navarre Avenue, OH Phone: / Fax: Mercy St. Anne Hospital* , West Avenue, OH Phone: , 5624, OH Northwest Ohio Endoscopy , Monroe Street, Suite 111, OH Phone: Hours: M-F 7am - 2pm Svcs: EN , South Reynolds Road, OH Phone: , Lewis Avenue, OH Phone: Parkway Surgical Center, Ltd.* , Executive Pkwy., OH Phone: / Fax: Reconstructive & Aesthetic Surgery Center, , North Reynolds Road, Suite 250, OH Phone: / Fax: Hours: M-Th 8am - 5pm, F 8am - 4pm Surgery Center at Regency Park* , Regency Court, Suite 101, OH Phone: Hours: M-F 6:30am - 4:30pm The Hospital*, OH Hours: 24 hour/7days The University of Medical, OH Clinic Outpatient Surgery , 3514, OH Phone: Hours: M-F 6:30am - 4pm West Central Surgical Center, LLC* , West Central Avenue, OH Phone: / Fax: Hours: M-F 7am - 3:30pm GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology

4 Wildwood Surgical , North Reynolds Road, Suite 190, OH Phone: / Fax: Hours: M-F 8am - 4:30pm Aetna "Select Provider" Listing - Ambulatory Surgery Note(s): Some ambulatory procedures require the physician to notify Aetna prior to performing services (e.g., colonoscopy and other scope procedures). These procedures were not used to determine this listing. GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 2 of 2

5 ALLEN COUNTY Lima Sleep Center of Lima* , West Market Street, Suite 200 Lima, OH Phone: / Fax: Hours: M,T,F 8:30am-4pm, W 8:30am-4:30pm, Th 9am CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital* , North Sandusky Avenue , North Sandusky Street ERIE COUNTY Sandusky Northern Ohio Medical Specialists , West Strub Road Sandusky, OH Phone: FULTON COUNTY Wauseon The Clinic* , South Shoop Avenue Wauseon, OH Phone: HANCOCK COUNTY Findlay Blanchard Valley Hospital* , South Main Street Findlay, OH Phone: , Holland Road, OH Phone: , OH Aetna "Select Provider" Listing - Sleep Studies Sleep Disorders Center, Ltd.* , Holland Road, Suite 300, OH Phone: / Fax: , Isaac Streets Drive, Suite 139, OH Phone: , Navarre Avenue, OH Phone: / Fax: Sleep Disorders Center, Ltd.* , Navarre Avenue, OH Phone: Primary Care Center, , Avenue, Suite E, OH Phone: / Fax: , Hughes Drive, Suite HMT 820, OH Phone: / Fax: Secor Sleep Diagnostic Center, L.L.C.* , Secor Road, Suite A, OH Phone: / Fax: Sleep Network of, Inc. Dba The Regional Center for Sleep Medicine* , West Avenue, Suite 202, OH Phone: / Fax: Hours: M-F 8am-4pm The Clinic*, OH SANDUSKY COUNTY Bellevue The Bellevue Hospital* , West Main Street Bellevue, OH Phone: / Fax: Fremont Memorial Hospital* , South Taft Avenue Phone: / Fax: , South Taft Phone: , South Taft Avenue Phone: WOOD COUNTY Bowling Green Wood County Hospital , West Wooster Street Bowling Green, OH Phone: Perrysburg Perrysburg Family Physicians, L.L.C.* , Commerce Drive, Suite 160 Perrysburg, OH Phone: / Fax: Physician Diagnostic Sleep Technology Specialists LLC* , West South Boundary Perrysburg, OH Phone: / Fax: