Where We Stand
Section: Health Care Financing
Policy: Radiology Prior Authorization Programs
Radiology Prior Authorization Programs
OMA will charge the Health Care Finance Committee to make the issues of economic credentialing and prior authorization for imaging services required by some health plans a high priority.
Adopted at the annual House of Delegates, 2006.
OMA physicians review criteria currently used by radiology prior authorization programs that is benchmarked against established clinical systems and develop guidelines as educational tools for physicians as well as a uniform standard of quality.
- The OMA will review the criteria/guidelines used by the American Imaging Management (AIM) to assure that they are consistent with nationally endorsed American College of Radiology (ACR) guidelines.
- If AIM guidelines are consistent with ACR guidelines that the OMA disseminate these to its members.
- The OMA shall review processes used by AIM to identify policies and procedures that create undue administrative burdens for physician practices.
- The OMA work collaboratively with its members and health plans in Oregon to persuade AIM to reduce administrative burdens of physician practices.
- The OMA facilitate the flow of information used by AIM for prior authorization to radiologists to assure the most appropriate study is performed.
Adopted at the annual House of Delegates, 2008.
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