Wednesday, 8 August 2012

Oklahoma Health Care Authority (OHCA) has partnered with MedSolutions to provide authorization for Radiology services to Medicaid members

Effective from November 1, 2010 all outpatient elective CT, MR, and PET studies require authorization from MedSolutions OHCA Medicaid members.

Services require prior authorization

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

We can request authorization in three ways as below
  • Website       - (registration required)
  • Phone          -        888-693-3211 (Monday to Friday @ 8.00 AM to 9.00 PM EST)
  • 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 patient 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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