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Providers

Approval Information for Radiological Services

An outpatient diagnostic imaging program is active (since September 1, 2006) for individual and group members of Arkansas Blue Cross and Blue Shield health plans, except for members of Medi-Pak, Medi-Pak Advantage, Access Only, AR Health (where Medicare is primary), BlueCard (check with home plan if not Arkansas) and the Federal Employee Program (FEP).

Physicians are required to secure prior approval for the following outpatient procedures: CT Scan, MRI/MRA, Nuclear Cardiology and PET Scan.

Arkansas Blue Cross utilizes National Imaging Associates (NIA) - an independent company - to provide prior approval of health plan coverage services. For more detailed information, please see the Radiology Management Guide or Reminders.

Radiology Management Reference Guide [pdf, 584 KB] — Detailed information regarding the new prior approval program for outpatient diagnostic imaging services.

Radiology Management Reminders [pdf, 93 KB] — Follow these tips to expedite the prior approval process.