Tuesday, 7 August 2012

Keystone Mercy Health Plan has partnered with MedSolutions to provide authorization Radiology and Nuclear Cardiology services

All outpatient elective MR, CT, PER and Nuclear Cardiology and OB Ultrasound performed from September 1, 2011 requires prior authorization from MedSolutions.

Services require prior authorization

All outpatient, non-emergent, diagnostic imaging services including:
  • CT
  • MR
  • PET
  • Nuclear Cardiology
Services do not require prior authorization
  • Inpatient radiology
  • Radiology testing done in the Emergency Room
  • 23 hour observation
  • SPU
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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