MRI authorisation with Sanitas: portal, documentation and traceability

What is verified about Sanitas for authorisations

Sanitas maintains a Provider Portal at medicosblua.es through which clinics can request authorisations. The exact validity window for Sanitas MRI authorisations and the preferred channel (clinic or patient) by imaging subtype is not confirmed in public sources and depends on the specific clinic agreement. Clinics must measure real Sanitas behaviour rather than assume transversal rules.

Usual MRI request documentation

An MRI request always shares the same documentary core, regardless of the insurer: clinical report justifying the indication, prescription with the prescribing physician identifier number, procedure code (MRI with or without contrast, anatomical area) and ICD-10-ES diagnosis code. When any of these fields arrives incomplete, rejection happens at first review and the imaging schedule slips.

Where revenue leaks in MRI with Sanitas

The most frequent leakage in Sanitas MRI does not appear in the initial denial but in the gap between authorisation date and actual appointment date. If the appointment moves, the authorisation hangs and the authorisation number on the invoice does not match the act date. The insurer may request a resubmission, adjust the tariff or return the invoice for date inconsistency. Recurring cost is low per unit, high in volume.

How SaludComply approaches it

SaludComply measures first. How many Sanitas MRIs the clinic performs monthly, what percentage end with valid authorisation on the actual appointment date, how many invoices are returned for date inconsistency and how many authorisations expire before being used. From that baseline, the authorisation agent prepares resubmissions, aligns dates and leaves the final decision to the clinic billing lead. Human approval before every submission remains the rule.

Verified sources

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