Wednesday, 8 August 2012

MO HealthNet has partnered with MedSolutions to provide authorization for Radiology services

Effective from July 19, 2010 select MR, CT, PET, and Cardiac imaging studies requires prior authorization from MedSolutions.

Services require prior authorization

All outpatient, non-emergent, diagnostic imaging services including
  • CT
  • MR
  • PET
  • Cardiac Imaging
Services do not require prior authorization
  • Inpatient and observation stay radiology
  • Radiology testing done in the Emergency Room
  • Outpatient radiology services other than those indicated
How can we request prior authorization from MedSolutions?

We can request authorization in three ways as below
  • Website       - (MedSolutions available via CyberAccess Website also require one time registration)
  • Phone          -        800-392-8030, Option #5 (Monday to Friday @ 7.00 AM to 8.00 PM CST)
  • Fax              -        888-693-3210 (fax forms available at MedSolutions web portal)
What we need to request authorization from MedSolutions?
  • The patient’s name & address
  • The current Recipient 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
Authorization number will be faxed to ordering physician and requesting facility.


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