OB/GYN & ABDOMINAL ULTRASOUNDS

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Most insurance companies will reimburse the costs for medical diagnostic procedures and apply your payment towards your deductible. Contact your insurance provider for requirements.

If needed, we can provide you a receipt with documentation of the most common criteria needed for insurance reimbursement including: 

 1. CPT code

 2. ICD-10 code 

 3. Patient name, date of birth 

 4. Ordering provider signature, printed name, credentials and facility contact info

 5. Final report from a board certified radiologist

 6. Itemized statement of charges 

 

Share  this form  with your provider to be completed or they can provide you with their own.  Once received, we will reach out to get you scheduled. Please contact us if you need assistance with getting the provider to complete the order.