If you or an attorney can get the doctor s office to file the form wc 205 this is an additional way that you can move forward with getting treatment approved if your doctor is willing to send that form wc 205. This can be very frustrating.
But the mri will probably not get scheduled if the insurance company does not approve it.
How long does it take to get an mri approved by workers comp. Some states also have strict deadlines for approving or denying a claim often between 14 and 30 days. An mri offers your doctor a more complete picture of your condition along with providing important evidence that your injury is work related. In most states the employer or insurance company must decide whether you re eligible for workers comp benefits promptly or within a reasonable time period.
Because each insurance company has it own requirements and process for authorization it can be hard to predict how long your authorization will take. If the insurance company is delaying approval of your mri there are several steps you can take to move the process along. You should get a personalized case evaluation from a licensed attorney.
Laws change frequently and across jurisdictions. Find a local attorney to give you a free case review here or call 888 972 0892. Most mri testing facilities will want the insurance company to approve the mri before they schedule an appointment for you.
The above is general information. The insurance company is given five business days to respond to that form and either approve the treatment or deny it. How long will it take to get authorization for my procedure or mri.
The shoulder injury medical treatment guidelines state that rotator cuff repair for partial thickness rotator cuff tears may be appropriate no pre authorization required if certain subjective objective and imaging findings are present and if adequate conservative treatment lasting 3 6 months was completed. That would change the mind of the peer review dr. It is the mri facility which contacts the insurance company for the approval.
In some circumstances you can schedule the mri at the facility but often by the time you are taking the appointment they already know if insurance approval was received. And all would be approved. Sometimes the doctor orders the mri and you receive a call a few days later that it has been scheduled.
We wish you the best with your claim injury claim coach. Within 2 weeks of resubmitting with the wording they wanted to see it was approved 1 week later the surgery was done. Some only take a few days while others can take weeks for your insurance company to approve.
A week is a bit long. Regardless the mri facility will be waiting for your doctor s request.