TUFTS Joins HPHC in Radiology Prior Approvals

Tufts Health Plan (THP) now requires prior authorization for outpatient CT, MRI, nuclear cardiology and PET scans through National Imaging Associates (NIA). BWPO physicians, however, are exempt from calling NIA for approvals as long as the test is ordered using Percipio, which provides requisite image ordering decision support.

If you and your office staff do not use Percipio, all future THP radiology requests for CT, MRI, nuclear cardiology and PET scans at BWH outpatient facilities will require that you contact NIA and receive an authorization number before the test can be scheduled. This policy is similar to that for Harvard Pilgrim Health Care patients. 

Blue Cross Blue Shield Massachusetts plans to institute prior authorization for HMO Blue patients starting in December, and plans are being made to inform you of implications for ordering imaging tests for these patients as well.

Those with questions about operational issues should contact Michael Delvecchio in Radiology at mdelvecchio@partners.org