Radiology Prior Authorization FAQs
- How do I search for the facility I wish to perform the scan?
-
Using the NPI of the facility is the most efficient way to locate the facility. Other options include a name search or a tax id search. IMPORTANT: Only use one search field at a time.
- When I search for a facility I do not get the address I expected. Can you explain?
-
Today the facility may have only one NPI/address on file with MO HealthNet, however, facilities are completing accuracy assessment questionnaires for each location at which they perform one of the listed codes. Additional locations / addresses associated with the same provider NPI will be loaded as the provider fulfills the assessment requirements for each site.
- Do I need a prior authorization for a patient in observation care?
-
No. While this was required in previous policy, we no longer require prior authorization for a patient in observation care.
- If a participant has Medicare Part B, do they need prior authorization for these services?
-
No.
- What if I don't know the NPI for the facility where I am referring the participant?
-
You may want to check with the facilities where you frequently refer patients and get their NPI. You may also search the NPI registry.
- What is DiagnosticSite?
-
The DiagnosticSite Assessment Program (formerly RadSite) is a medical imaging safety and quality program designed to assess the medical imaging equipment, personnel and policies of facilities that perform diagnostic imaging services. DiagnosticSite administers the assessment on behalf of various health plans and networks.
- Who is required to participate in this assessment?
-
All physician offices and all facilities that provide imaging services are required to participate in this program. This involves all imaging performed, including CT, MR, PET, radiography, ultrasound, nuclear medicine, fluoroscopy, nuclear cardiology, angiography, DEXA, and mammography.
- How do facilities participate?
-
The easiest way to enter information is to do it online. Many features, such as dropdown menus, make the process faster and more accurate than doing it on paper. Please contact our program support team at 800-506-2560 and a customer support professional will be happy to assist you.
- Can I contact DiagnosticSite for assistance?
-
Certainly! If we can do anything to improve your DiagnosticSite certification experience, please feel free to contact our program support team with any questions you may have.
E-mail: SiteSupport@Healthhelp.com
Phone: 800-506-2560
Fax: 800-546-7081 - Where can I find additional information?
-
You can find additional information at the HealthHelp website: https://portal.healthhelp.com/mohealthnet.