MRI Prior Authorization Process
Your provider will order an MRI at your appointment.
Your MRI facility is based on your PCP affiliation, proximity to your home, etc. Any specific requests should be made at the time of the order being placed. We are more than happy to schedule at a facility that is most convenient for you.
This order is sent to the SSO prior auth. department who will start working on this within 24-48 hrs. The process starts with SSO completing an initial request; submitting clinical information for review, to ensure the service meets the established guidelines within your health insurance plan.
If prior authorization is required from your insurance plan, the request is sent to the insurance company in which they typically respond within 1-3 business days.
Once the MRI has been approved, the MRI order is faxed to one of the local facilities who will then contact you directly to schedule your exam. This ensures patients getting an appointment that works with their availability.
After your MRI is performed, a copy of the report will be sent to our office. SSO staff will contact you directly to schedule a follow up appointment and/or discuss the results over the phone.
Please allow 3-5 business days for the office to obtain this approval. The turnaround time may take longer depending on your insurance plan requirements. Contact the office with any additional questions or concerns/requests.
A prior authorization is the process of healthcare providers obtaining approval from a health plan before a specific procedure is performed to be certain the testing qualifies for payment coverage. An authorization is not a guarantee of payment. Authorizations are based on medical necessity & are contingent upon eligibility & benefits. Benefits may be subject to limitations and/or qualifications & will be determined when the claim is received for processing.