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Q: What is Ultrasound?

Answer:  Ultrasound, or Sonography, is an imaging modality that has many amazing applications in evaluating health and wellbeing. Because Ultrasound is non-ionizing, it can be performed on patients of all ages without Known bioeffect, rendering it virtually harmless when used in moderation.

High frequency sound waves (ultrasonic) are emitted into the body providing important information for diagnostic evaluation of human anatomy. Because ultrasound images are captured in real-time, they can show the anatomic structure of the body, internal organs and blood flowing through blood vessels, as well as, helpful information about the unborn child. You can learn about all the different ways Ultrasound can be used on Men, Women and Kids by going to the Diagnostic-Medical Ultrasound tabs of our website where we highlight all the different types of medical-diagnostic ultrasounds we perform at Picture Perfect Ultrasound.

Ultrasound has shown its relevancy not only in the evaluation of the unborn child, but in physiologic and anatomical evaluation of most of the body’s internal organs. Evaluating men, women and children of all ages is possible using 2D (two dimensional), 3D (three dimensional) or 4D (four dimensional) Ultrasound technology.

Picture Perfect Ultrasound specializes in Diagnostic Ultrasound in many applications. Our staff is Licensed, ARDMS or RCIS-RCS Credentialed & Experienced in providing the highest quality Ultrasound imaging using the latest Ultrasound equipment and technology available.

DIAGNOSTIC ULTRASOUND:  Picture Perfect Ultrasound performs Diagnostic Ultrasounds for medical imaging. All Diagnostic ultrasounds require a physician script/referral prior to performing exam. We are a diagnostic imaging clinic for men, women and children of all ages.

Every patient has a choice of where to get their Ultrasound imaging performed.


We can accept any patient for a diagnostic ultrasound if they have a physician script verifying the type of exam to be performed. Our Sonographers perform diagnostic ultrasounds are reviewed and interpreted by a general supervising physician/Radiologist or Cardiologist.

When you visit your physician and he/she decides you need an Ultrasound, consider calling Picture Perfect Ultrasound to schedule your appointment.  Your referring physician will get the results of your exam with a formal report- interpretation from our Licensed Radiologists or Cardiologists. We do have PACS which allows us to securely send your ultrasound images to your referring physician so your physician can "see" the images as well as get the reports.


Any Ultrasound that is requested by a patient to be performed for non-diagnostic purposes is considered “elective”. Insurance companies do not cover elective ultrasounds unless medically necessary or warranted.

Choosing to have an Elective 2D, 3D/4D Ultrasound should NEVER replace the Diagnostic Ultrasound

that should be performed between 18-22 weeks of pregnancy.  


Having a diagnostic ultrasound is extremely important to evaluate the health and well-being of your baby. You can choose to have your Diagnostic Ultrasound performed at Picture Perfect Ultrasound or at the facility of your choice. Picture Perfect Ultrasound recommends that patients have a diagnostic ultrasound prior to choosing any type of elective ultrasound for non-medical purposes.

If you do choose to have a 2D or 3D/4D Elective Ultrasound, please let your physician know of your request. We welcome your physician, provider or licensed midwife referrals for Elective Ultrasounds. Our staff at Picture Perfect Ultrasound encourages all patients to stay in contact with their physician or medical providers in the event you have further questions or concerns. Elective Ultrasound sessions are not covered by Insurance and therefore you will need to pay for your session by Cash, Gift Card or Credit Card prior beginning your Ultrasound.

The ideal time to get a 3D-4D Ultrasound performed is between 26 to 33 weeks pregnant; however, 3D-4D Ultrasound can be performed anytime from 15 weeks to 33 weeks. If you are pregnant with twins or multiples, it is recommended to have a 3D-4D performed between 20 and 26 weeks pregnant.

Q: What is required in order for me to be able to get an ultrasound done? 

Answer:  All diagnostic or medical ultrasounds do require a provider, physician or practitioner referral that shows the exam is being ordered for medical purposes. Picture Perfect Ultrasound requires this referral or order/script to be received prior to your exam being started. If your physician wishes you to hand carry the referral that is fine. However, my physician offices and practices prefer to FAX the referral directly to Picture Perfect Ultrasound. They can do so by faxing to (406) 969-4341.  If we do not received your physician order prior to your appointment, we will reach out to your provider and seek that referral on your behalf.  

Patients cannot choose to receive medical or diagnostic ultrasound imaging without a physician order or script. Your insurance, Medicaid or Medicare will also require this order prior to processing your claim for services rendered.

Some insurance plans do require pre-authorization or prior authorization on cardiac ultrasounds. While most plans do not, your referring physician office will help facilitate a pre-auth request if needed prior to you getting your exam done.   Medicaid does sometimes require passport authentication (which is a Medicaid assigned passport-patient ID#- not the typical passport used for a traveler)

Q: Can any physician I choose receive my Ultrasound test results? Will my referring physician get the results?

Answer:  When a patient is referred to Picture Perfect Ultrasound, we do ensure that the referring physician receive results from the diagnostic Ultrasound exam performed by us. Every physician prefers to receive their reports differently but no matter the method, your physician will receive results the same day your exam is performed. All of our diagnostic ultrasounds are interpreted by board certified, licensed Radiologists or Cardiologists. Your referring physician will receive results with final reports and interpretation from our Radiologists / Cardiologists.

You do have the opportunity to fill out a medical release form that allows Picture Perfect Ultrasound to send results of Ultrasounds with or without images to any physician or provider you designate. With your approval, we will send the information you request only to the designate physicians you reference on the release form.

We accept referrals, physician orders and scripts from all medical providers. If your particular provider does not have access to an order form and would like to use our blank order form, your physician can download it, print it and order the appropriate exam for you. 







Q: I am referred by a physician out of Billings or Out of State, how can my referring provider know about my Ultrasound & get my results?

Answer:  Picture Perfect Ultrasound has state of the art Ultrasound equipment that has digital capabilities which allows a referring physician to review any Ultrasound performed in our clinic. We have a PACS (Picture Archiving Communication System) that makes sending reports or images secure and efficient no matter where a physician is located.

We do abide by HIPAA guidelines and follow safety measures to ensure all data, images or reporting sent through our PACS system is sent through a secure network. Patients are welcome from any location or provider (in-state or out-of-state). At your request we can provide reports or images of your exam to whatever physician or facility you designate. We have medical information release forms available in our office that you can fill out to give us approval and direction of where to send your information.

Local Physicians, in and around Billings, can view ultrasounds through their own network PACS:  SCL Health (ST V), Billings Clinic have access to our images once we push them onto their network through a secure portal.

We have the ability to burn a CD or disc of your ultrasound imaging study that can be mailed, at your request or your physicians request, if they do not have access to PACS.




Q: How do I request my medical records or obtain a copy of my ultrasound results so I can share them with another provider I am seeing?

Answer:  You can request to receive a copy of your medical records for services performed at Picture Perfect Ultrasound by phoning our office at (406) 969-4340. We are open Monday-Friday 7:30am to 4:30pm MST. You can also choose to print the request or permission forms from our website. 

Medical Records Release Form:





Q: Who is responsible for interpreting my Ultrasounds performed at Picture Perfect Ultrasound?

Answer:  ALL of the Ultrasounds performed at Picture Perfect Ultrasound are reviewed & read by Licensed Board Certified Physicians who specialize in body imaging. Diagnostic Ultrasounds require a physician interpretation to generate a final report of any findings from your Ultrasounds. This report is generated once the Radiologist or Cardiologist reviews your Ultrasound and then dictates this final report. All final interpretations are sent to your referring physician directly from the Radiologist or Cardiologist. Our general interpreting physician group is ERA (Eastern Radiological Associates) here in Billings, MT. They are specialized in interpretation of all ultrasounds as well as interpret for other facilities that do MRI, X-ray, CT etc.  For cardiology reads, we work with a group of Licensed Cardiologists who specialize in cardiac imaging specifically.

The Sonographer or Ultrasound specialist performing your Ultrasound will provide the "technical" portion of the exam and the Licensed Radiologist will provide the "professional physician" portion of the exam. Please understand it is the role of the physician to interpret Ultrasound exams and diagnose patients not the Sonographer. We do want you to be comfortable and understand the exam being performed therefore the Sonographer can help answer any questions regarding the prep or procedure.  We do encourage all patients to return back to their referring physician for the results of their Diagnostic Ultrasound.

For Elective Ultrasound imaging, such as 3D-4D Obstetric Packages, our OB-Physician Medical Director has access to these images but no formal physician report is generated since this is not a medical ultrasound. If there is a concern or a possible abnormality is noted during one of these elective sessions, our Medical Director will be in contact with the patients primary care physician to facilitate a referral of the patient back to that primary care provider. It will be up to the patient's primary care physician discretion as to whether further Diagnostic testing or specialized consult is necessary. Picture Perfect Ultrasound does have protocols in place that we follow to ensure patient safety in both routine and emergent situations.


The Radiologist or Cardiologist who interprets your diagnostic-medical ultrasound will bill separately than Picture Perfect Ultrasound. The Radiologist or Cardiologist will bill only the professional component called (PC); essentially the reading fee or final doctor interpretation of your ultrasound.  Picture Perfect Ultrasound only bills the TC or technical portion of the ultrasound performed in our imaging center.


Click Here to View all of the Interpreting Radiologists for Picture Perfect Ultrasound:  




Q: How will I be billed for services rendered at Picture Perfect Ultrasound?


Answer: When you arrive to our office you will be asked to fill out paperwork pertinent to yourself, responsible party for billing (insurance etc). In order for Insurance or Medicaid, Medicare to process, we will need to get a copy of your insurance cards to submit the exam charge and information from your exam. Picture Perfect Ultrasound bills only the TC (Technical component) of your ultrasound; meaning we only bill the performing of the exam, staff and equipment used for your exam. Once your insurance has processed, you will receive a bill from Picture Perfect Ultrasound for any remaining balance due, copays etc. 


Also while doing paperwork at check-in, we will go over the information about the Radiologists or Cardiologists. They are the doctors who read ultrasound and they bill separately from Picture Perfect Ultrasound. They bill only the PC (Professional component) of your exam. Here is the information about APS: the billing company ERA (Eastern Radiological Associates), the interpreting physicians, use for billing. Picture Perfect Ultrasound does not have any affiliation with APS and will not be responsible for anything that APS does on behalf of ERA or their clients. 

Here is the information about the interpretation process and the billing company ERA uses:    





For Cardiology Interpretation and Billing Services: You will receive information about the cardiology specific billing company at check-in.

Q. What is a Medical Director, what is their role and why does Picture Perfect Ultrasound feel it is important to have Medical Directors designated for their facility?

Answer:   Picture Perfect Ultrasound's Medical Directors are licensed, board certified physicians who provides guidance, oversight, and quality assurance for our entire facility. Our Medical Directors review ultrasound scans, help implement referral back to the customer’s primary care provider in emergency situations, and ensures that Medical Device Reporting procedures are in place along with routine preventative maintenance checks.

Picture Perfect Ultrasound feels it is very important to have qualified board certified physicians serving in our Medical Director roles as well as being the Professional Staff that provide quality, professional interpretations on our ultrasounds. Our physicians are committed to excellence and maintain their credentialing, licensures and continuing education to stay abreast of the changes within healthcare.

Picture Perfect Ultrasound has two Medical Directors overseeing the ultrasounds performed by our staff. The Medical Director overseeing all Diagnostic Ultrasound is a licensed, board certified Radiologist (physician specialist in imaging). The Medical Director overseeing all Diagnostic OB and Elective OB Ultrasounds (2D/3D/4D) is a licensed OB-GYN Physician.

Q. What Qualifications or Experience does the Sonographer or Ultrasound Specialist have?

Answer:   Picture Perfect Ultrasound requires that all Sonographers (Ultrasound Technologists) be ARDMS Credentialed.  ARDMS (American Registry of Diagnostic Medical Sonographers) is the governing organization that oversees the Ultrasound profession and the members performing Ultrasound. In order to maintain credentialing and registries, Sonographers are required to have continuing education and are held accountable to that. Because there are many specialties within Ultrasound, we require our Sonographers to be well versed in all aspects of ultrasound to provide our patients the most comprehensive service possible.

In order to become ARDMS Credentialed, a person must have graduated from an Accredited Ultrasound School and/or shown competency in performing Ultrasound under general supervision of licensed physicians. Once a person has met the criteria of scanning experience and has the approval of physicians, they can sit for the medical boards (tests) that pertain to each specialty they wish to be credentialed or accredited in. If a professional passes these medical boards, then they are then deemed Credentialed and are required to maintain that credentialing by continuing their education yearly.

Cardiac Sonographers have had specialized training and education in heart and vascular imaging. These sonographers are also required to have registry and credentialing by the agencies that relate safe cardiac imaging practices.   RCIS and RCS are common credentials earned by Cardiac sonographers and continuing education is required to keep these credentials.

Picture Perfect Ultrasound has an amazing team of qualified, experienced Sonographers. Learn more about our Team here! 



Q: Who is Buffy Stiles and what is her medical background?

Answer:  Buffy Stiles RT(R) RDMS RVT is the Owner and Lead Sonographer for Picture Perfect Ultrasound. Buffy started out attending college for pre-med. She then was accepted into a 2 year JCAH accredited Radiologic Technology School (X-ray) in Montana where she passed the Radiology medical boards to earn her RT(R) Credentials. Immediately following Radiology school,


Buffy advanced her education attending an AMA-CAHEA Accredited Ultrasound School in Colorado. Upon graduating from Ultrasound school, Buffy immediately challenged the Ultrasound boards and earned her RDMS credentialing in 1993. Buffy took the medical boards for Vascular Technology and Vascular Physics in 1995 of which she passed and earned her RVT Credentials. Buffy has worked in the Ultrasound specialty since 1993 performing all aspects of Ultrasound .   Buffy continues to advance her education and takes continuing education classes throughout the year.

Q: Does Picture Perfect Ultrasound accept Insurance?

Answer: YES!   Picture Perfect Ultrasound does accept many types of Insurance. For a complete list of the insurance companies we do currently accept, please check out the "PAYMENTS" tab. In addition to accepting Insurance, we also accept Medicare, Medicaid, Indian Health Services (IHS) and self-pay patients.

You can view our PAYMENTS page to view our accepted methods of payment. You can also inquire with your insurance company to be sure that ClearView Sonographics LLC (doing business as) Picture Perfect Ultrasound is covered under your specific plan.


Q: I received an EOB (Explanation of Benefits) from my Insurance company and it says the company that billed my ultrasound service was called ClearView Sonographics LLC but I had my ultrasound done at Picture Perfect Ultrasound. Is this wrong? 

Answer:  No, it is not wrong. ClearView Sonographics LLC  DBA (doing business as) Picture Perfect Ultrasound and so they are one in the same company. NOTE:  We are known to the public as Picture Perfect Ultrasound solely. Some insurance companies require the tax business ID and that is why your insurance  company might have listed ClearView Sonographics as the services rendered location.  No worries! This is not wrong. 

Q: I need an Ultrasound but unfortunately do not have Insurance. Can I still have an Ultrasound performed with Picture Perfect Ultrasound?

Answer:  YES!  We do accept patients that are Self-pay. We give a 15% discount for exams paid in full at the time service is rendered.  We accept debit cards, credit cards or cash.

If you are a self-pay patient and cannot pay your exam total at time of service, we are unable to extend the 15% instant discount and we will need to collect a minimum of half of your exam fee prior to exam starting. You are then able to set up payment arrangements with us for any remaining balance due.

Q: I have Insurance with a really high deductible. My doctor wants me to get an Ultrasound performed so what should I expect as far as payment?

Answer: We understand patients may have deductibles that are not met. We want to work with you to provide your service but also help you process your visit so you get credit towards your deductible. Picture Perfect Ultrasound will perform your Ultrasound and submit your visit to your insurance company so that your exam can be counted towards your deductible.


We are in-network providers with most insurance companies and you may receive further discounts, depending on your insurance plan. Once we have heard back from your insurance company via an EOB (Explanation of Benefits) on what possible discounts or credits you may have received, (specific to your insurance plan), we will then send you a bill for any remaining unpaid portion. It will be your responsibility, as the patient, to pay for any exam fees remaining if insurance pays partially or not at all.


We do require payment in full within 90 days from date of receipt of billing invoice. We do accept down-payments at the time of service that will apply to any outstanding balance you may have after Insurance processes. However upfront down-payments are not required.

Q: I see that my Ultrasound exam charges are divided into two different fees? Why did I receive two different bills or EOB's?

Answer: Every diagnostic ultrasound is comprised of two parts: the technical piece and the professional interpretation piece. Picture Perfect Ultrasound performs the technical side of each Ultrasound performed and our licensed, board certified Radiologists (physicians) provide the professional interpretation piece of each ultrasound performed. No matter what type of diagnostic ultrasound you receive, both the technical and the professional fees charged are based off of CPT Codes.

You will receive two separate charges specific to each exam you have performed. Picture Perfect Ultrasound bills for the technical exam charge only for diagnostic exams performed. Our Radiologists use their own billing service to collect the professional interpretation charge only. This is why you might see two different fees charged or receive two separate invoices billing different amounts. If you have any questions about the technical fees assigned to diagnostic ultrasounds performed at Picture Perfect Ultrasound, contact us at (406) 969-4340.  The interpreting Radiologists, ERA (Eastern Radiological Associates) bill the PC using their own billing company called APS. Picture Perfect Ultrasound does not have any affiliation to APS and does not have access to their records, billing files etc. If you have questions about the APS bill from the Radiologists, you will need to call APS directly. Picture Perfect Ultrasound will not be held liable for anything that APS does, collects or files. 


The Cardiologist(s) who interprets the heart ultrasounds will be billing the PC or professional component through their own methods. You will receive a bill directly from their billing company for any balance from the interpretation of your exam. You can make payment arrangements directly through them for this PC portion if you wish. 

                                            Here is the Contact Info for APS (Billings Company Radiologists Use)

Q: Is the Ultrasound equipment safe to use on my body?

Answer: YES,  Ultrasound is safe when performed by qualified knowledgeable staff utilizing quality ultrasound equipment. It is necessary to maintain quality assurance on all medical equipment used in healthcare. Picture Perfect Ultrasound has a service contract with qualified personnel who are trained to service, monitor and maintain Ultrasound equipment. We follow FDA guidelines for safe usage with regards to scanning time parameters and power levels to comply with State and Federal guidelines. Ultrasound has no known detrimental effects when used in moderation with proper usage of equipment by trained personnel.

In addition to following safety guidelines, it is equally as important to have qualified personnel performing the Ultrasounds. This is to ensure the staff is trained and aware of appropriate equipment controls and usage. Picture Perfect Ultrasound ONLY employs ARDMS registered and credentialed Sonographers to perform our Ultrasounds. Each sonographer has continuing education requirements each year that keep us abreast of safety, technology or application changes.

Q: I want to bring my children and my family to my Ultrasound appointment. Are they allowed to come?

Answer: Absolutely!  Picture Perfect Ultrasound is a family friendly Imaging center where we encourage patients to bring their loved ones to their Ultrasound (children, friends or family are welcome!) We do have a family-kids waiting room that makes waiting for your appointment stress-free. Let the kids hang out and play in that waiting area and when it is time for your appointment, they can join you during your Ultrasound. We have large scanning rooms, plenty of seating and large viewing monitors making everyone's experience enjoyable. 

Q: Do you have Gifts Available to Purchase that anyone can buy whether they are a patient or not?

Answer:  We have gift certificates available for each of our Elective Ultrasound packages that can be customized to any dollar amount to be redeemed for gifts or for Elective Gender Reveal or our 3D-4D sessions. We have custom Keepsake Sound cards for purchase that can record a personal voice message OR we can record your baby's heartbeat in the card for you to take home or mail to a special Loved one!

NEW!  We now have Pink or Blue Teddy bears and a new FUN variety of 16" stuffed animals for sale that are also recordable with the baby's heartbeat! Customize these with your baby's heartbeat within. Each time you squeeze the stuffed animal, you will hear the your baby's special heartbeat! You are going to love these stuffed animals, in stock for you to take home or give as a gift to that special someone.

Check out our Electives 2D-3D-4D Ultrasound Packages 

 Learn more!  VIEW PACKAGES


Frequently Asked Questions

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Picture Perfect Ultrasound is an ACR Accredited Ultrasound Facility specializing in Ultrasounds for
Men, Women and Kids of all ages. 





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