Ordering physician's or professional provider's name, address and telephone.Patient’s identification number, name and date of birth.Information NeededĮnsure you have all the following before requesting a Prior Authorization or RQI from Carelon: Refer to the Carelon On-demand training page for available sessions. Medical records for pre or post-service reviews are not necessary unless specifically requested by Carelon.Īttend free training sessions on how to submit requests for Carelon Prior Authorizations and Radiology Quality Initiatives (RQI).Provides faster pre-service decision turnaround times than post service reviews.Offers self-service, smart clinical algorithms and in many instances real-time determinations. However, if you do not obtain an RQI number before providing Advanced Imaging services and the services are subsequently deemed not medically necessary, claims payment will be impacted.īenefits of the Carelon ProviderPortal for Pre & Post-Service Reviews:
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