Rad preauth

Radiology services

Preauthorization for radiology benefits is administered by HealthHelp®, a nationally recognized specialty benefit management organization. Preauthorization is required for radiology services. The terms prior authorization, precertification, preadmission, preauthorization and notification are all used to refer to the preauthorization process.

Exclusions from the preauthorization requirement include the following:

  • Florida, California and Nevada Medicare Advantage (MA) health maintenance organization (HMO) members
  • Atlanta MA HMO members
  • Ochsner commercial and MA HMO members
  • Health Care Partners MA HMO members
  • Chicago risk and delegated providers

For Medicare Advantage Private Fee-for-Service (PFFS) plans, notification is requested, but it is not required.

Submitting preauthorization requests

Preauthorization for any radiology treatment plan ordered for a Humana-covered patient, including MA PFFS notification, is administered through HealthHelp’s online program, RadConsult, or by phone. These treatment plans include computerized tomography (CT) scans, magnetic resonance angiograms (MRA), magnetic resonance imaging (MRI), nuclear stress tests, positron emission tomography (PET) scans and single-photon emission computerized tomography (SPECT) scans.

Submit a request by phone

Phone: 1-866-825-1550

Available 7 a.m. to 7 p.m., Monday through Friday and 9 a.m. to 4 p.m. CST, Saturday

Submit a request online

Health care providers may submit a request to RadConsult, HealthHelp's online program.

State-specific authorization forms

While HealthHelp recommends submission of authorization requests online or via telephone, the following forms may be used for authorization requests in specific states:

Texas authorization request form (438 Kb)

Physicians and other clinicians in Texas may use this form to submit authorization requests for their Humana-covered patients. Instructions are available here (127 Kb). Once complete, please fax it to HealthHelp at 1-888-863-4464. Include supporting clinical documentation (e.g., medical records, progress notes, lab reports, radiology studies, etc.) with your fax form.

Indiana authorization request form (760 Kb)

Physicians and other clinicians in Indiana may use this form to submit authorization requests for their Humana-covered patients. Instructions are included on the form. Once complete, please fax it to HealthHelp at 1-888-863-4464. Include supporting clinical documentation (e.g., medical records, progress notes, lab reports, radiology studies, etc.) with your fax form.

Additional resources

Humana Radiology Benefit Management

Learn more about this program and the patient information required when requesting preauthorization or providing notification.

(194 KB) Download PDF

English

Consult™ Online tutorial

Learn how to request, schedule and follow up on imaging services and treatment plans for your Humana-insured patients online with Consult Online by reviewing this tutorial.

(1.66 MB) Download PDF

English

Questions

If you have technical questions about the RadConsult preauthorization system, please contact RadConsult support staff at rcsupport@healthhelp.com or call 1-800-546-7092. Assistance is available from 8 a.m. to 6 p.m. CST Monday through Friday.

For clinical questions, call 1-866-825-1550. Assistance is available from 7 a.m. to 7 p.m. Monday through Friday and from 9 a.m. to 4 p.m. CST Saturday.