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OUTPATIENT IMAGING PRIOR AUTHORIZATION FAX REQUEST FORM Attn: Paramount U/CM Department Toll Free Phone Number: 18008912520Fax: 5676610844Network Provider Preservice Request RAMA SCORE:| ELITE | COMMERCIAL/HMO
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How to fill out outpatient imaging prior authorization

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How to fill out outpatient imaging prior authorization

01
Contact your healthcare provider to discuss the need for outpatient imaging.
02
Obtain the necessary prescription or referral from your healthcare provider.
03
Contact your insurance company to determine if outpatient imaging prior authorization is required.
04
Complete any required forms or provide any requested information to your insurance company.
05
Follow up to ensure that the outpatient imaging prior authorization has been approved before scheduling the appointment.

Who needs outpatient imaging prior authorization?

01
Patients who have insurance coverage that requires prior authorization for outpatient imaging.
02
Healthcare providers who need to ensure that their patients receive the necessary authorization for imaging services.
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Outpatient imaging prior authorization is a process used by health insurance providers to require healthcare providers to obtain approval before a patient undergoes certain imaging tests, such as MRIs or CT scans, to ensure that they are medically necessary.
Typically, the healthcare provider or facility performing the imaging service is required to file outpatient imaging prior authorization on behalf of the patient.
To fill out outpatient imaging prior authorization, a healthcare provider must complete a designated form provided by the insurance company, including patient information, details of the requested imaging procedure, clinical information justifying the necessity of the scan, and any relevant medical history.
The purpose of outpatient imaging prior authorization is to help manage healthcare costs by ensuring that certain imaging procedures are medically necessary and appropriate before the services are provided.
The information that must be reported includes the patient's personal information (name, date of birth), details about the imaging procedure, clinical justification for the imaging request, previous treatment history, and any relevant diagnostic information.
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