Anthem changes coverage policy for MRIs, CT scans at hospitals

Indianapolis-based Anthem stopped covering outpatient MRIs and CT scans at hospitals without prior approval, according to the Indianapolis Business Journal.

Anthem wants its members to avoid hospital imaging services and instead opt for a cheaper alternative at a freestanding facility.

Hospitals will need to submit a precertification request for any patient receiving an MRI or CT scan at the hospital. The imaging service will only be covered at the hospital if Anthem deems the request medically necessary.

The policy took effect July 1 in Indiana, Wisconsin, Missouri and Kentucky. On Sept. 1, the policy will expand into Ohio.

The insurer has not disclosed the amount of money it expects to save or what prompted the policy change, according to the report.

To learn more about the change in policy, read the FAQ from Anthem. 

More articles on payer issues:
BCBS of North Carolina to drop grandfathered health plans; 50k affected
Anthem expands discretionary ED coverage policy to Indiana 
MemorialCare Health System back in-network with Anthem Blue Cross

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