Required as of March 1, 2014: Prior Authorizations (PA) for CT and PET Scans
February 28, 2014
Services date on or after March 1, 2014 will require a PA for CT and PET scans. This change applies to all MaineCare Members between ages 21 – 64.
A live webinar demonstration on how to request PAs for these services will be available for Pathways Radiology. Training will include information about pended PAs and what information is required for a PA decision. There will also be a question and answer session after the demonstration.
Below are the dates of the webinars. Each webinar will be take place from 3:00 – 4:00 PM.
Prescribing Physicians: 02/26/14 03/05/14 03/12/14 03/19/14
Radiologists: 02/21/14 02/28/14 03/07/14 03/14/14
Please email: Hilary.McIntire@MolinaHealthCare.Com to register for a webinar. The Pathways Radiology PA Request Guide, which gives you instructions on the portal enhancements, can be found in the Health PAS Online Portal, in the Authorizations Pathways folder
• Portal enhancements will allow PA requests for these CT and PET scans. With the enhancements, you will receive an immediate response to your PA request, resulting in a PA auto approval or pend.
• Appropriate documentation is required with all CT and PET PA requests.
• If your PA request results in a pend status, please upload a copy of the Radiology Supplement form titled “P.A. Request Form – Pathways Radiology.” You do not need to have the member’s demographic section completed. See section 16 of the Pathways Radiology PA Request Guide.
If you have trouble uploading the document, or have any questions, please call Provider Services at 1-866-690-5585.