TM Contracted Health Plans October 2014 To ensure testing is billed correctly, please provide the following information on the test requisition: Patient Name, Address, Sex, DOB, ICD-9 Codes, Ordering Phys. & NPI, Policy ID #, Policy Group #, Claims Address, Insured & Relationship Health Plans & Government Plans Accountable Health Plans, Inc. Aetna Healthcare - All Products - Preferred Provider (Includes AARP under Aetna) Arizona Foundation for Medical Care (Maricopa Foundation) Arizona Medical Network/Rural Arizona (AMN-RAN) (HMA, Inc.) Arizona Priority Care Plus (AZPCP) Banner Health Plans Banner Health Network - All Products Beech Street BC/BS of Arizona - All Products - Preferred Provider CIGNA Healthcare of Arizona - All Products Coventry/Community Care Network (CCN)/First Health First Health Lab Program/Mail Handlers/National Association of Letter Carriers Fortified Provider Network, Inc. Galaxy (formerly Managed Care, Inc.) GEHA (Government Employees Health Association) GHI (Group Health Insurance) Great West Healthcare (formerly One Health) Health Management Network (HMN) (HMA, Inc.) Health Net - All Products Hotel Employees & Restaurant Employees Union (Nevada) HPN (Health Plan of Nevada) Humana/Choice Care Network - All Products - Preferred Provider LabCard/LabCard Select/Lab One Medical Mutual of Ohio Medicare - All Plans Mediversal (Nevada) Meritus Health (Compass Cooperative Mutual Health Network) Multiplan/Admar Med Network Mutual of Omaha NAMM Contract (Aveta Physicians) PCAP (Pima County Access Program) (HealthCare Connect) PCIP (Pre-Existing Condition Insurance Plan) PHCS (Private Health Care Systems) Shasta Jeld-Wen/Secor Sierra Health & Life Insurance (Nevada) Tricare/UHC Military Services - In-Network Provider TriWest VA PCC (Veteran’s Patient Centered Community Care) Unicare Union Benefits of America/United Benefits of America UnitedHealthcare - Contracted with Laboratory Sciences of Arizona and serviced by its subsidiary Sonora Quest Laboratories Universal Health Network (Nevada) USA Health Net (USA Managed Care Organization) Workers Compensation - All Plans Exclusive AHCCCS Plans Exclusive Arizona Dept. of Economic Security Disability (DES/DD) Capstone Care 1st - All Products Cenpatico Behavioral Health CMDP/Foster Children CODAC Behavioral Health Health Choice Acute (members in Apache, Coconino, Gila, Mohave, Navajo, Pinal, and Santa Cruz counties) Health Choice Generations - All Counties Health Choice Insurance Co. (Health Insurance Marketplace Product) - All Counties Health Net Access IHS - Indian Health AHCCCS (American Indian Health Plan) Maricopa Health Plan (MHP) - All Products (Maricopa Managed Care) Mercy Care - All Products - ONLY Contracted Laboratory Mercy Maricopa Integrated Care - ONLY Contracted Laboratory Nevada Medicaid Pima Health Systems RMAP/Refugee Medical Assistance Plan University Family Care/Univ. Phys. Health Plan (U of A Health Plans) Medicare Replacement Plans Exclusive All Medicare Replacement/Dual Eligible plans offered by Contracted Health Plans on this list AARP Medicare Complete insured through UnitedHealthcare (Banner Health Network ONLY) Banner (BHN) / BC/BS of AZ Blue Advantage (MediSun) Bridgeway CareMore Group Health Co-Op Health Choice Generations - All Counties Kaiser Permanente Pyramid Life - Today’s Options SCAN Health Plan Arizona/Healthcare Partners Sterling Options Tenet Choices U Care UnitedHealthcare Medicare Direct WellCare Medicare Advantage Plans not contracted with Sonora Quest Laboratories: AARP Medicare Complete insured through UnitedHealthcare (Lifeprint Network, Phoenix Direct Hospital Network, and Pinal Network) CRS [Children’s Rehabilitative Services (APIPA)] Evercare Lifeprint Network Health Choice Acute (Members in Maricopa & Pima counties only) Phoenix Health Plan (a.k.a. Abrazo) UnitedHealthcare Community Plan (Medicaid; formerly APIPA) Sonora Quest Laboratories accepts all Health Insurance Marketplace plans offered by the contracted health plans on this list *Indicates changes or additions from prior printing | FES (Federal Emergency Services) is not a laboratory coverage plan and must be client or patient responsibility. 1. Please note: This list contains Sonora Quest Laboratories most commonly billed health plans and is not all-inclusive. If you have questions regarding a specific health plan please contact your Account Manager. 2. Sonora Quest Laboratories is a participating provider for ALL testing services (clinical, anatomic pathology and esoteric). Claims will be filed for all Sonora Quest Laboratories contracted payors listed above. Other insurance plans not listed will generate a Patient Bill that the insured individual may submit for reimbursement. Please be aware that this list is subject to change and there may be exceptions for certain members or products. If you have any questions regarding our participation with a specific product or health plan, please contact your Account Manager. For our most current listing, or to sign up for our Client Portal for online bill pay and supply orders, visit SonoraQuest.com