RadConsult: NYS Medicaid Program to Implement a Radiology Management Program
04/08/11
04:24:21 pm, by Kristina Giyaur 
, 151 words 
Categories: News and Announcements, Medicare and Medicaid
RadConsult: NYS Medicaid Program to Implement a Radiology Management Program
The New York State Medicaid Program is preparing to implement a new peer consultation program applicable to outpatient non-emergency advanced imaging procedures. RadConsult, administered by HealthHelp is supposedly aimed to improve quality and reduce cost of care by providing expert peer consultation and the latest medical criteria for diagnostic imaging.
In actuality, what does this mean for healthcare providers? If you are a physician orderign a CT, CTA, MRI, MRA, Cardiac Nucler or PET procedure for a Medicaid fee for service patient, you or your office staff are required to obtain a prior approval number through the RadConsult program. If you are a provider performing one of the above diagnostic imaging tests you must verify that an approval has been obtained for the Medicaid beneficiary. The prior approval will be required for claim payments and failure to obtain an approval number may delay or prevent payment of a claim for such radiology services.
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