Tuesday, 7 August 2012

Physicians Health Choice has partnered with MedSolutions to provide authorization for Radiology services

All outpatient elective MR, CT, and PET studies performed on or after March 1, 2011 require prior authorization from MedSolutions.

Services require prior authorization
  • CT/CTA
  • PET
  • Outpatient high tech imaging studies
  • Elective/Non-emergent high tech imaging studies
Services do not require prior authorization

High tech imaging studies performed in
  • Emergency Room
  • Inpatient
  • 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 @ 7.00AM to 8.00PM CST)
  • 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

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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