PHYSICIANS USE / PRE-CERTIFICATION

We will need the following information to pre-certify all breast MRI's.

1. Patient demographic sheet.
2. Copy of insurance card.
3. Order to state bilat breast w/wo contrast with diagnosis.
4. Copy of all breast reports (mammo, US) for the last year.

Please fax the following information to 850-215-4045 attn: pre-cert

Once we have certified the procedure with the patient's insurance we will call the patient to schedule the appointment.