The below files are to be used as a guide when referring patients for imaging services at the Outpatient Diagnostics Center or SampsonRMC.
The above pre-authorization chart is to be used as a guide. It is best to verify authorization for all patients as each patient's policy requirements may vary.
Items Needed for Pre-Authorizations
- Patient's Insurance ID Number
- Ordering Provider's Name & Tax ID #
- CPT Code of Requested Exam
- Prior Labs, Exams, Treatment, etc.
- Facility Information: Sampson Regional Medical Center, 607 Beaman Street, Clinton, NC
- NPI# 1609857432