Automatic Approval Process for Advanced Imaging Prior Authorization

This document is a provider memorandum detailing the automatic approval process for advanced imaging prior authorization through Molina Healthcare of Illinois. It outlines the use of MCG Cite AutoAuth, a self-service tool designed to expedite prior authorization requests for high-cost advanced imaging procedures. The memorandum explains how providers can attach relevant clinical guidelines to authorization requests, which are then matched against Molina's criteria for potential automatic approval. If the criteria are not met, the request will pend for further clinical review. The document also provides access information for the Cite AutoAuth tool via the Molina Availity Essentials Portal, along with tips for ensuring timely reviews of requests. Additionally, it emphasizes the importance of including clinical notes and other necessary documentation to avoid delays or denials in the authorization process. Contact information for further assistance is also provided.