How should providers request prior plan approval?
Providers will find complete instructions on how to request prior plan approval outlined on the diagnostic imaging procedures page. Ordering physicians for BCBSNC members must obtain prior plan approval prior to scheduling an imaging exam for outpatient diagnostic, nonemergency services. Performing providers (hospitals and freestanding imaging centers) should confirm that a prior plan approval number was issued. Only ordering physicians can obtain a prior plan approval number. Hospitals and freestanding imaging centers that perform the imaging services cannot obtain the number. Issuance prior plan approval is not a guarantee of payment. When submitted, the claim will be processed in accordance with the terms of a subscriber’s health benefit plan.
