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The Radiology Prior Authorization Request Form is designed to facilitate the process of obtaining prior authorization for elective outpatient radiology services. It requires specific information from the requesting physician, including patient details, service types, and clinical documentation to support medical necessity. All mandatory fields must be completed to avoid delays in processing.

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2009	4 Satisfied (27 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the fax number for 1 800 540 2406?

Fax an eviCore healthcare request form (available online) to 800-540-2406; for sleep study requests fax to 888-693-3210.

What is the turnaround time for eviCore prior authorization?

In the event of clinical urgency, eviCore healthcare will render a decision within 72 hours of the request. What is the decision time limit for a routine prior authorization decision? eviCore healthcare will render a decision on a routine prior authorization request within 14 calendar days of the original request.

What is the phone number for Tmhp prior authorization?

Call the TMHP PCS Prior Authorization Inquiry Line at 1-888-648-1517 and ask whether an authorization is in process.

What is the phone number for eviCore DME?

Providers and/or staff may also contact eviCores call center by calling 800.298. 4806.

What is the phone number for eviCore prior authorization form for radiology?

eviCore healthcares prior authorization call center is available from 8:00 a.m. to 9:00 p.m. Eastern Standard Time, Monday through Friday. The phone number is (888) 693-3211.

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How do I contact eviCore for prior authorization?

How can I initiate a prior authorization request? The quickest, most efficient way to obtain prior authorization is through the 24/7 self-service web portal at .evicore.com. Prior authorization can also be obtained via phone at 855.252. 1117.

How do I submit a prior authorization to Medi Cal?

Pharmacy providers and prescribers can submit a PA request via fax number 1-800-869-4325 by utilizing the preferred Medi-Cal Rx Prior Authorization Request Form or any of the following approved forms: 50-1, 50-2, 61-211.

Get the up-to-date Radiology Prior Authorization Request Form - TMHP.com 2025 now

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Got questions?

What is the fax number for 1 800 540 2406?

What is the turnaround time for eviCore prior authorization?

What is the phone number for Tmhp prior authorization?

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What is the phone number for eviCore prior authorization form for radiology?

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