Coverage & costs

Insurance, billing,
and what to expect.

We believe cost shouldn't be a mystery. This page covers what insurance typically covers, how prior authorization works, and what to do if you're paying out of pocket. When in doubt, call us — we'll look it up for you.

Accepts Medicare
Yes
For covered procedures with documented medical necessity
Commercial insurance
Most major plans
Call to verify your specific plan before scheduling
Referral required
No
You can book a consultation directly — no referral needed
Benefit verification
We do it
Our office verifies your coverage before scheduling any procedure
Accepted insurance

Plans we work with.

We accept Medicare and most major commercial insurance plans. If you don't see your plan listed or aren't sure whether we're in-network, call us at (818) 418-8165 — we'll verify your specific benefits at no charge before you schedule anything.

Medicare
We accept Original Medicare (Parts A & B) as well as most Medicare Advantage plans. GAE, RFA, and image-guided injections are covered when medical necessity criteria are met.
Most commonly used by our patients
Commercial insurance
We work with most major commercial insurers including Anthem Blue Cross, Blue Shield of California, Aetna, Cigna, and UnitedHealthcare. Coverage and in-network status vary by plan.
Call to confirm in-network status for your specific plan
Review before launch: confirm which commercial carriers you're credentialed with and update this list accordingly.
Not sure?
We verify benefits on your behalf before scheduling any procedure. You'll receive a written summary of expected coverage and estimated out-of-pocket costs — no surprises.
No charge for benefit verification
How coverage works for IR procedures

What insurance typically covers — and what affects it.

Coverage for interventional radiology procedures like GAE and RFA is generally good, but it's not automatic. Most insurers require prior authorization — a review process where the insurer confirms the procedure is medically appropriate for your situation before approving it. We handle this process for you.

Coverage strength for each procedure varies, but the general pattern is: the more conservative treatments you've already tried and documented, the stronger your prior auth case. A patient who can show two years of cortisone injections, physical therapy, and failed NSAID treatment is far easier to authorize than one with no documented history.

Procedure Medicare Commercial Typical prior auth?
Genicular Artery Embolization (GAE) Covered Varies by plan Yes — usually required
Radiofrequency Ablation (RFA) Covered Widely covered Yes — requires positive diagnostic block first
Image-guided joint injections Covered Widely covered Usually no — straightforward to bill
Hip & shoulder embolization Case-by-case Varies by plan Yes — newer procedure, coverage expanding
Prostate Artery Embolization (PAE) Covered Varies by plan Yes — requires documented BPH and failed medical therapy
Initial consultation Covered Covered No

Coverage status is based on published payer policies and is subject to change. Always verify your specific plan before scheduling.

Prior authorization

We handle prior auth for you.

Prior authorization sounds bureaucratic — and it is — but it's a routine part of scheduling procedures like GAE and RFA. Here's the sequence from your first call to procedure day.

01

Benefit verification

When you call or submit the assessment, we contact your insurer and verify your specific benefits, deductible status, and whether the procedure you're interested in requires prior authorization under your plan. You'll hear from us within one business day.

02

Consultation with Dr. Dhand

At your consultation, Dr. Dhand reviews your imaging, documents your clinical history, and determines which procedures you're a candidate for. This documentation forms the basis of the prior authorization request.

03

Prior auth submission

Our billing team submits the prior authorization request to your insurer with the supporting clinical documentation. Most decisions come back within 3–14 business days depending on the insurer and procedure.

04

Scheduling

Once authorization is approved, we schedule your procedure. You'll receive a written summary of your expected cost-sharing — copay, coinsurance, or any deductible that applies — before the day of the procedure.

05

If authorization is denied

Denials happen and they're not the end of the road. Our billing team reviews the reason and, if the denial is inappropriate, prepares an appeal on your behalf with additional documentation. We'll explain your options clearly and never pressure you into proceeding without understanding your coverage.

Self-pay & uninsured

No insurance? We can still help.

We offer self-pay pricing for patients without insurance coverage, patients whose plans don't cover a specific procedure, or patients who prefer to pay out-of-pocket. Self-pay pricing is discussed transparently at consultation — there are no hidden fees and no surprises.

Questions about cost? Just ask.

The fastest way to understand your exact situation — whether you have insurance or not — is a single phone call. We can tell you what to expect financially before you ever come in. There's no charge for that conversation.

(818) 418-8165
Mon – Fri · 8:30 am – 5:00 pm
Or take the assessment
Common questions

Billing questions we hear most often.

No referral is needed to schedule a consultation. Interventional radiologists can be seen directly by patients, just like a specialist visit. That said, some insurance plans require a referral for the consultation to be covered — it's worth a quick call to your insurer to check. We can also help you verify this when you contact us.
This depends on your specific plan — your deductible status, coinsurance percentage, and whether you've hit your out-of-pocket maximum for the year. We provide a written cost estimate before scheduling any procedure. There are no surprise bills. If the estimate concerns you, we'll talk through it before you commit to anything.
In most cases, yes — medical procedures performed by a licensed physician are qualified medical expenses for Health Savings Account (HSA) and Flexible Spending Account (FSA) purposes. We recommend confirming with your plan administrator, but we can provide the itemized documentation you'd need to submit for reimbursement.
A denial isn't always final. Many first-round denials are overturned on appeal when additional clinical documentation is submitted — particularly for newer procedures like GAE. Our billing team reviews every denial and advises you on whether an appeal is worth pursuing and what additional documentation would strengthen the case. We've been through this process many times and will walk you through every step.
Depending on where your procedure is performed, you may receive separate bills from the facility (if applicable) and from the physician. We'll explain this clearly at the time of scheduling so you know exactly what to expect. Your benefit verification summary will reflect both components where relevant.
Let us know as soon as possible. Insurance changes can affect coverage and prior authorization status — it's easier to re-verify and re-authorize before the procedure date than to deal with billing issues afterward. Just call us at (818) 418-8165 and we'll re-run your benefits under the new plan.

Ready to find out if you're covered?

Take the two-minute assessment and our office will follow up with a benefit verification for your specific plan — before you're asked to schedule anything.

Take the assessment

Prefer to call? (818) 418-8165 · Mon – Fri, 8:30am – 5pm