Authorization for MRI, CT and PET-CT in private insurance
Authorization for MRI, CT, PET-CT or scintigraphy concentrates around high-cost tests with stricter clinical review. ASISA publishes that CT, MRI, PET, scintigraphy, vascular/interventional radiology and nuclear medicine require authorization; MAPFRE distinguishes basic tests from non-routine diagnostics. The clinic should control exact code, clinical suspicion, site, date and authorization number before confirming the appointment.
Complex diagnostic tests almost always need authorization
ASISA publicly confirms that CT, MRI, PET, scintigraphy, vascular and interventional radiology and nuclear medicine all require prior authorization. MAPFRE separates basic tests from non-routine diagnostic tests such as MRI and endoscopy.
Calculate revenue lost to authorisations
Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.
Minimum data per imaging request
Per request: patient, professional, exact code, clinical suspicion, laterality and region if applicable, contrast yes or no, site, approximate date and insurer.
How to prevent the appointment from being performed without confirmed authorization
Do not block final agenda capacity until the authorization is approved, except for urgent acts. Link the authorization number to the act before any other administrative action.
Why this case is a priority in a daily queue
These cases sit high in the daily queue: high unit cost, frequent complaints and stricter clinical review by the insurer. SaludComply checks prescriber, code and justification before sending.
Verified sources
- ASISA — Qué servicios tengo que autorizar — TAC, resonancia, PET, gammagrafía, radiología vascular
- MAPFRE — Prestaciones que necesitan autorización — pruebas diagnósticas no habituales