High-tech radiology auth approval process
Imaging facilities need an authorization prior to performing any high-tech radiology service on a patient in order to be reimbursed.
The approval process for high-tech radiology authorization requests
- The physician sends AIM an authorization request documenting the medical necessity of the requested radiology service. View required information.
- An AIM referral specialist receives the request and all pertinent clinical information related to the request.
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Medical necessity review:
- The referral specialist may approve the request immediately or refer it to an AIM Registered Nurse for review;
- The nurse may approve it or refer it to a physician reviewer;
- The physician reviewer may approve it or discuss it with a clinician at the requesting provider's office.
- The request cannot be denied by anyone other than a physician reviewer, or without discussion with the requesting provider.
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Approval or denial:
- You will be notified by AIM through a form email or, if the auth requires a physician review, by the physician reviewer.
- An authorization is not complete until AIM issues an authorization number to the physician and to the imaging facility scheduled to perform the service. If a service is performed before receiving approval authorization, provider payment will be denied.
- Requests that do not meet medical necessity criteria will be denied.
- AIM will provide an advisement on alternative studies or procedures appropriate to the case.
