Who is responsible for obtaining the prior authorization/pre-service determination of medical necessity?
It is the prescribing physicians’ (i.e., Primary Care Physicians and specialists) responsibility to contact CCN through the toll-free number, for a prior authorization/pre-service determination of medical necessity for AIS exams. CCN will not accept a request for a prior authorization/pre-service determination of medical necessity from the rendering provider. However the rendering provider should verify if prior authorization was given or a pre-service necessity was made, by calling CCN at 1-866-496-6200 or verify on the Web site: www.carecorenational.com. Back to Top Will CCN accept a call from the radiology facility regarding prior authorization/ medical necessity? CCN will accept calls from the Horizon participating radiology facility within 2 business days of the performed procedure for any upgrading or downgrading of AIS procedures. Please Note: Upgrading of procedures will require the facility to justify the need for the upgrade with CCN. Back to Top How does the physician prior
