Advanced Imaging Prior Authorization Submission Guide

This document is a provider memorandum from Molina Healthcare of Illinois regarding the submission of Advanced Imaging Prior Authorization (PA) requests through the Availity Essentials portal. It outlines the benefits of using the portal, which include improved processing times, real-time authorization responses, and enhanced efficiency and compliance with HIPAA regulations. The memorandum details the partnership with MCG Health to offer Cite AutoAuth (CAA) for high-cost imaging PA requests, allowing for expedited responses by matching clinical information with care guidelines. Best practices for submitting requests are provided, emphasizing the importance of attaching comprehensive clinical notes and avoiding common pitfalls that could lead to denials. Additionally, it informs providers about the discontinuation of access to the Molina Legacy Provider Portal and encourages the use of the Availity Essentials portal for streamlined claims management and authorizations. Contact information for further assistance is also included.