Tuesday, 7 August 2012

AmeriHealth Mercy Health Plan has joined with MedSolutions to provide authorization for Radiology services

AmeriHealth has changed vendor from National Imaging Associates, Inc to MedSolutions Inc to provide prior authorization for radiology services effective from October 1, 2011

Services require authorization

Outpatient MRI, MRA, CT Scans, Nuclear Cardiac and PET imaging studies will require prior authorization.

Services do not require authorization

Imaging studies performed in conjunction with an inpatient stay, 23 hour observation, short procedure or emergency room visit still do not require authorization.

How to request authorization from MedSolutions?

We can request authorization from MedSolutions in three ways as below
  • Website       - (registration required)
  • Phone          -        800-572-1981, Option 2 (Monday to Friday @ 8.00AM to 9.00PM EST)
  • Fax              -        888-693-3210 (Fax forms available in MedSolutions web portal)
What we need to request authorization from MedSolutions?
  • The patient’s name & address
  • The current Member ID
  • The procedure code and working or differential diagnosis code
  • 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

Authorization requests will be processed within 2 business days and faxed to ordering physician and requested facility.
Patient also receives the copy of authorization through mail from MedSolutions.


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