Thursday, 19 July 2012

Vermont Medicaid has contracted with MedSolutions to provide prior authorizations for Radiology services

Effective from September 1, 2010 all outpatient elective CT, MR, and PET studies require prior authorization from MedSolutions for Medicaid recipients residing within state of Vermont.
Services require prior authorization
  • CT/CTA
  • PET
  • Prior authorization applies to high tech imaging studies that are:
  • Outpatient
  • Elective / Non‐emergent
Services do not require prior authorization
  • Emergency Room
  • Inpatient
  • 23 hour observation
  • Outpatient emergencies (Post authorization required)
How can we request authorization from MedSolutions?

We can request authorization from MedSolutions in three ways.
  • Website      - (registration required)
  • Phone         -        888-693-3211 (Monday to Friday, 8AM to 9PM EST)
  • Fax             -        Fax authorization request to 888-693-3210. Fax forms available in MedSolutions web portal but other fax forms cannot be accepted.
Processing authorization requests

Authorization requests processed within 3 business days after the review. Decision is faxed to ordering physician and requested facility.

These authorizations are valid for 60 days from the date issued.


Post a Comment