Diagnostic Study Advance Disclosure Notification

Disclosure:

The Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010,
requires physicians who refer patients for MRI, CT and/or PET scans/services and also provide the scans/services
to inform Medicare patients in writing, at the time of the referral, that the patient may obtain the advanced imaging
services (MRI, CT and/or PET) from other suppliers. 

Your Legacy physician determined that you need a Magnetic Resonance Imaging (MRI) scan and you are a Medicare patient.
Federal law requires your physician to inform you in writing at the time of the MRI referral that you may obtain the MRI from
Legacy Neurosurgery Spine and Brain Specialists, one of the alternative suppliers listed below, or any other supplier of your
choice.  Below is a list of alternative suppliers within a 25-mile radius of our office.  The following list is meant to provide you
with freedom of choice and does not constitute an endorsement or recommendation of any one supplier or provider.

  1. Arkansas Specialty MRI Center, 600 S McKinley St. Little Rock, AR 72205, 501-978-2192
  2. RAPA, 500 S University Ave, Little Rock, AR 72205, 501-664-3914
  3. Chenal MRI, 11300 Financial Centre Parkway, Little Rock, AR 72211, 501-211-2502
  4. Baptist Health Imaging Center, 3600 Springhill Dr NLR, AR 72117
  5. Baptist Health Imaging Center, 2400 N Rodney Parham Little Rock, AR 72212, 501-202-6750