DO MRI STUDIES NEED TO BE DONE WITHIN MPN? (California)

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DO MRI STUDIES NEED TO BE DONE WITHIN MPN? (California)

Postby spreare on Wed Apr 03, 2019 10:08 am

When provider receives an auth for MRI's. do they need to be within the preferred or MPN network? IE, are MPN's "catch-alls?" thanks
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Re: DO MRI STUDIES NEED TO BE DONE WITHIN MPN? (California)

Postby LawAdvocate on Wed Apr 03, 2019 1:17 pm

If the MRI facilities are actually within the MPN yes.

However, generally (not always) the carrier or administrator is referring you to their preferred vendor. So if you look it up on the MPN website and it is not there, the patient can go to the facility of choice, based on your arguing lack of access - that 3 facilities are not available within 30 miles. Most people have no time to fight this issue, so it is not fought on a very frequent basis, because of the prevailing opinion is an MRI is an MRI, yet when we get to the medical-legal stage, it seems to me (anecdotally) that the images from the preferred vendor are always deemed to be of a poor quality and then the medical-legal physician gets an MRI at the facility of their choice. So I guess employers don't mind paying for the same MRI twice or they would tell the carriers and the administrators to knock it off.
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