Wednesday, 11 July 2012

BCBS Rhode Island Radiology Authorization Process

Effective from January 1, 2011 facilities no longer submit prior authorization requests on behalf of ordering physicians. Ordering physician offices need to request authorization from MedSolutions.

Patient enrolled in BCBS of RI, except non-managed classic, the federal employee plan, Plan 65 and New England Health Plans are eligible to request prior authorization for radiology services.

Services require authorization:
  • CT/CTA
  • PET
  • Nuclear Cardiac Studies
Prior authorization applies to high-tech imaging studies that are:
  • Outpatient
  • Elective/Non-emergent
Services do not require authorization:
  • Emergency Room
  • Inpatient
  • 23-hour observation
  • Outpatient emergencies (Post authorization required)
How the provider request authorization from MedSolutions?
  • Website          -           Request through (registration required)
  • Phone             -           We can request by calling to 888-693-3211 (Monday to Friday @ 8.00 AM to 9.00 PM)
  • Fax                  -           We can send fax request to 888-693-3210 (MedSolutions fax forms only accepted and it available at their website)
All authorization requests will be processed within 2 business days upon the review. Approval letter faxed to ordering physician and requesting facility.

Authorizations are valid for days from date of request.


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