Monday, 9 July 2012

Coventry has tied up with MedSolutions to provide Radiology and Cardiology Authorizations

Coventry Healthcare has tied up with MedSolutions to request prior authorization for Radiology and Cardiology services. It was implemented on September 1, 2010 for their members living in the state of Maryland.

Services require authorization
All outpatient, non-emergent, diagnostic imaging services including
  • CT / CTA
  • MRI / MRA
  • PET
  • NCM / MPI
Services not require authorization
  • Inpatient radiology
  • Radiology testing done in the Emergency Room
  • 23 hour observation 

How can we request authorization from MedSolutions? 

We can request authorization from MedSolutions in three ways as below.
  • Through Website   - (Registration required)
  • Through Phone      - 888-693-3211 (Availed on Monday to Friday at 8AM to 9PM)
  • Through Fax          - 888-693-3210 (we need to MedSolutions fax request form only. It’s available in their website)

 What kind information requires for authorization request?

 To request authorization by website, phone or fax below details are required.
  • The patient’s name & address
  • The current patient ID
  • The working or differential diagnosis
  • Prior tests, lab work and/or imaging performed related to this diagnosis
  • Notes from the patient’s last visit related to the diagnosis
  • Type and duration of treatment performed to date for the diagnosis
Finally MedSolutions will be faxed authorization number to requesting provider upon approval however there is no changes in the claim submission. So we can submit the claim continuously to Coventry Healthcare but the questions regarding authorization should be communicated with MedSolutions only.


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