MRI authorisation with MAPFRE: 48-hour window and direct access
What is verified about MAPFRE in diagnostic imaging
MAPFRE removed approximately 68,000 low-value imaging authorisations and opened roughly 90% of diagnostic imaging to direct access without prior authorisation. The imaging that still requires authorisation concentrates higher value. For procedures that still require authorisation, MAPFRE keeps an operational window of at least 48 hours before the procedure. Which specific MRIs still require authorisation under each agreement is not fully published and must be measured per centre.
The 48-hour window applied to MRI
The MAPFRE 48-hour window has a direct consequence in MRI: a short-notice appointment leaves no administrative time to prepare the request. A clinic that discovers a specific MAPFRE MRI does require authorisation, and discovers it the day before, falls out of window. The first operational mistake is not in the request itself, it is in knowing in time whether that scan falls in the group that still requires authorisation.
Where revenue leaks in MAPFRE MRI
MAPFRE MRI leakage has two faces. The first is a test performed as direct access when that specific agreement actually required authorisation, only discovered at billing time. The second is a request prepared outside the 48-hour window, arriving late and leaving the test without formal coverage. Both are detectable upstream with an appointment calendar tied to the MAPFRE list of procedures that still require authorisation.
How SaludComply approaches it
SaludComply crosses the clinic appointment portfolio with the MAPFRE rule for that imaging category. It flags tests that need an authorisation request, calculates whether at least 48 working hours remain before the procedure and prepares the request for the clinic admin to approve and submit to the MAPFRE portal. Human approval before every submission remains the rule.
Verified sources
- MAPFRE — Portal Profesional Sanitario — portal oficial del operador
- SaludComply — diagnóstico de autorizaciones — diagnóstico de fuga por autorizaciones
Related pages
Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.