Monday, 6 August 2012

HealthSpring has partnered with MedSolutions to provide authorization for Medicare Advantage Members

All outpatient elective cardiology, CT, MR, PET and Ultrasound studies performed on or after September 1, 2010 requires prior authorization from MedSolutions.

Services require prior authorization

All outpatient, non-emergent, diagnostic imaging services including:
  • CT / CTA
  • MRI / MRA
  • PET
  • NCM / MPI
  • Stress Echo
  • Ultrasounds
Services do not require authorization
  • Inpatient radiology
  • Radiology testing done in the Emergency Room
  • 23 hour observation
How to request authorization from MedSolutions?

We can request authorization from MedSolutions in three ways as below
  • Website       - (registration required)
  • Phone          -        888-693-3211 (Monday to Friday @ 8.00AM to 9.00PM)
  • 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 HealthSpring Member 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
Upon the decision MedSolutions will fax the authorization to ordering physician and requesting facility.


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