Referred (Ultrasound, DEXA, Vascular Ultrasound)

• Diamante Choice Platino
• Diamanto Extra Platino
• Premier Prefered Platino

Authorizations are required by the medical plan for:

• MRI
• CT
• MRA
• CTA
• PET-CT
• Nuclear Medicine

The pre-authorization is sought sending the medical order via fax to the medical plan.

• No authorization is needed for:
• Ultrasound
• Vascular Ultrasound
• DEXA

Medical orders are valid for 30 days.