Patient Billing

At Guilford Radiology, our goal is to be the lowest cost, highest quality provider in the area.  We strive to provide health care for anyone who needs it, regardless of their insurance coverage or ability to pay.

Guilford Radiology participates with a large network of insurance including all the major plans, Medicare and CT Medicaid plus many specialty plan and networks.  See below for our extensive list of networked insurance carriers.  Please note, this list is provided as a reference, participation is subject to change.  We can work with any patient, if there insurance is not listed we will contact their network for special exceptions and work with the patient for other options.

Patients should check with your insurance plan to verify network status and coverage. The list below is a reference, patients should check with your insurance plan for a complete list of providers and coverage. 

Insurance Prior Authorization

Some insurance plans require prior authorization for imaging procedures.  Guilford Radiology's insurance specialists can work with to obtain this authorization. For us to assist with any prior-authorization, we will need the patient’s insurance information, the order and all relevant clinical notes. 

You can fax this to us at (203) 458-0427 or scan and email to [email protected] (please ensure you have a secured email). 

Once we have obtained the authorization, we will contact the patient to schedule the exam and let you know when to expect the results.

If you have acquired the prior authorization, please provide the authorization number with your referral.

Imaging exams usually requiring preauthorization are, but not limited to:

Clinical Decision Support (CDS)

CMS now requires Clinical Decision Support CDS criteria under the Appropriate Use Criteria AUC

Beginning on January 1, 2020, the Protecting Access to Medicare Act PAMA act requires that physicians ordering advanced imaging exams consult Appropriate Use Criteria (AUC) through a qualified Clinical Decision Support Mechanism (qCDSM). Providers may use any (qCDSM) to meet this criteria.

Guilford Radiology is working with CareSelect – Open Access to assist our providers with the (qCDSM) qPLE access.  This resource is available to you at no charge. Click here to go to Care Select site and register for this service.  If you have not registered, you will need to click here to register on their site. Once registered, just click here to login.

A Comprehensive AUC Consultation Requirement

The PAMA requires that physicians ordering advanced imaging exams consult Appropriate Use Criteria (AUC) through a qualified Clinical Decision Support Mechanism (qCDSM). Ordering providers are required to consult AUC for all Medicare Part B Advanced Diagnostic Imaging Services (CT, MR, NM, PET).

Consultation is required in all applicable settings as outlined by CMS. These include physician offices, hospital outpatient departments (including emergency departments), ambulatory surgical centers, and independent diagnostic testing facilities.

CareSelect® Imaging - Open Access

CareSelect Imaging – Open Access has been developed in collaboration with our qPLE partners to enable widespread access to the tools needed for compliance with the Protecting Access to Medicare Act (PAMA).

The web application delivers a combination of Appropriate Use Criteria (AUC) published by qualified Provider-Led Entities (qPLE) including the American College of Radiology, the American College of Cardiology and the National Comprehensive Cancer Network, and the Society of Nuclear Medicine and Molecular Imaging and is fully qualified for use as a qCDSM under PAMA.  Click here to access Care Select.

Accessing CareSelect Imaging - Open Access

CareSelect Imaging – Open Access enables providers and their proxies to consult Clinical Decision Support and generate the required data for a payable claim for all advanced imaging exams as required by PAMA. This complimentary program is designed to streamline the referral segment of the radiology market and eliminate the need for duplicate CDSM consultation.

Provider Access and Consultation

CareSelect Imaging – Open Access is now available for provider registration. To access the portal, providers are required to register with their NPI and organizational information. Once registered, providers will gain immediate portal access and be able to generate compliant consultations. Click here to access Care Select.

Proxy Access

Clinical staff can act as ordering proxies under the direction of an ordering provider. Clinical staff members need to create their own Open Access accounts and utilize the “Change Ordering Provider” functionality within the web-application to consult on a provider’s behalf. This functionality allows for the proxy staff member to attribute the consultation to a provider’s NPI. CDS consultations will be visible on both the proxy.

Information on Clinical Decision Support

A Comprehensive AUC Consultation Requirement - The Protecting Access to Medicare Act (PAMA) requires that physicians ordering advanced imaging exams consult Appropriate Use Criteria (AUC) through a qualified Clinical Decision Support Mechanism (qCDSM).

​Ordering providers are required to consult AUC for all Medicare Part B Advanced Diagnostic Imaging Services (CT, MR, NM, PET).

Consultation is required in all applicable settings as outlined by CMS. These include physician offices, hospital outpatient departments (including emergency departments), ambulatory surgical centers, and independent diagnostic testing facilities.

Self-Insured/Self-Pay Clients

For our high-deductible plan and self-insured patients, we offer a competitive cash pay discount, including a same day prompt pay discount.  Call our office to discuss our self-pay options. In the case our facility is out-of-network, our staff is still happy to file a claim with your insurance company.  We can also work out a payment plan with you after insurance has paid its portion. 

It is our mission to provide quality diagnostic imaging services to everyone in Connecticut, regardless of financial circumstances. Contact us today with any questions or concerns!

Participating Insurance

Guilford Radiology participates with a large network of insurance including all the major plans, Medicare and CT Medicaid plus many specialty plan and networks.  See below for our extensive list of networked insurance carriers.  Please note, this list is provided as a reference, participation is subject to change.  We can work with any patient, if there insurance is not listed we will contact their network for special exceptions and work with the patient for other options.

Patients should check with your insurance plan to verify network status and coverage. The list below is a reference, patients should check with your insurance plan for a complete list of providers and coverage.

Note: Participation subject to change at any time.

Helpful Numbers

 Please note:

Contact us

Hours:
M-F 7:30AM to 5PM Late Wed. until 7PM
Sat. 8AM to Noon

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