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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

  1. The physician sends AIM an authorization request documenting the medical necessity of the requested radiology service.
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  2. An AIM referral specialist receives the request and all pertinent clinical information related to the request.
  3. Medical necessity review:
    1. The referral specialist may approve the request immediately or refer it to an AIM Registered Nurse for review;
    2. The nurse may approve it or refer it to a physician reviewer;
    3. The physician reviewer may approve it or discuss it with a clinician at the requesting provider's office.
    4. The request cannot be denied by anyone other than a physician reviewer, or without discussion with the requesting provider.
  4. Approval or Denial: 
  • AIM issues an authorization number to the physician and to the imaging facility scheduled to perform the service.
  • 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.


    Last modified 02/10/10