For Referring Physicians

Referral Form

For your convenience, download and print our Physicians Referral Form by clicking the button. Please CONTACT US with questions and to schedule an appointment for your patient.

Insurances Accepted

For your reference, see our MRI CPT coding guide:

PPO

• Blue Cross
• Blue Shield
• Aetna
• Cigna
• Health Net
• United Healthcare PPO
• SeeChange
• USA Managed Care Organization
• Tri-Care
• Beech Street
• PHCS
• CCN
• Humana
• MultiPlan
• Guardian
• Laborers Health & Welfare
• Santa Clara Family Health Plans

HMO

• PMG (Physicians Medical Group)
• Valley Health Plan
• Premier Care of Norther California
• Northern California Advantage Group
• Physician Partners

Personal Injury Liens

• Falling, Hecht & Davis Law Firm
• Attorney Julian J. Carash
• Boden Law Firm
• Key Health Management
• EDS Financial

Government Contracts

• Medi-Cal
• Medicare

Workers Compensation Networks

• AMR – Advanced Medical Resources
• Coast to Coast
• Diagnostic Village
• DRN – Diagnostic Radiology Network
• MedFocus
• MDIA
• MIS – Magnetic Imaging Services
• MMR – Medical Management Resources
• OCM – One Call Medical
• PDM – Professional Diagnostics Mgmt
• Select MRI
• Techhealth
• US Dept of Labor
• US Imaging
• Precise Imaging
• Next Image

PACS

PremiereScan is committed to providing you with up-to-date, easily accessible patient information, in conformance with HIPAA security standards. On this site you can access patient diagnostic reports and images, both historic and current.