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Thursday, 12 July 2012

BCBS of Delaware has contracted with MedSolutions to provide Radiology Authorizations

All outpatient elective MR, CT, and PET studies performed from September 1, 2010 require prior authorization from MedSolutions.

Services require prior authorization
  • CT/CTA
  • MRI/MRA
  • PET
Prior authorization applies to high-tech imaging studies that are
  • Outpatient
  • Elective / Non-emergent
Services do not require prior authorization
  • Emergency Room visits
  • Inpatient or 23-hour Observations
  • Performed with an Outpatient Surgery
  • Outpatient Emergencies (retrospective authorizations required)
How we can request authorization from MedSolutions?
  • Website       -        We can request authorization through online by registering in www.medsolutionsonline.com
  • Phone          -        Request authorization by calling 888-693-3211 (Monday to Friday at 8.00 AM to 9.00 PM)
  • Fax              -        Fax request needs to be sent @ 888-693-3210 (Only MedSolutions fax forms will be accepted. It available in their web portal)
How provider will require Authorization

Authorization requests will be processed within 2 business days. Authorization letters will be faxed to ordering physician and the requested facility.

Claim submission guidelines to BCBS of Delaware
  • Date of service must be within the effective date of MedSolutions authorization
  • Claim must match the CPT code for which the MedSolutions authorization was issued
  • Facility must match the rendering location for which the MedSolutions authorization was issued
  • Authorization number should not be included on the claim

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