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AI Agents for Radiology Prior Authorization
Prior Authorization Software for Radiology Centers
Notove AI is prior authorization software for radiology that confirms approval before the scan, so your schedule stays full. Notove detects which MRI, CT and PET orders need approval, gathers the clinical documentation, prepares the payer request and tracks the decision. Your team reviews and submits.
A scan without approval costs more than the scan
Imaging orders arrive from every specialty, and each one can carry a different payer rule. When approval is missing at the scheduling desk, the problem surfaces at the worst possible moment.
Lost appointment slots
The patient arrives, the approval is missing and the slot is lost. Your scanner sits idle while the patient waits for a new date.
Denied claims after the scan
A scan performed without approval can be denied after the fact. Your center absorbs the cost of a service it already delivered.
Hours lost to portals and phones
Schedulers move between your radiology information system (RIS, the software that manages imaging orders and appointments), payer portals and phone queues, one order at a time.
Physicians and their staff spend about 13 hours every week on prior authorizations, and practices complete roughly 39 requests per physician.
Source: AMA Prior Authorization Physician Survey, 2024
Imaging services that usually need approval
Requirements vary by plan, but advanced imaging is where approval rules are strictest. This is what typically triggers a request and what payers want to see. Each order is tied to a CPT code, the standard number that identifies the exact service.
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SERVICE
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WHY APPROVAL IS USUALLY REQUIRED
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DOCUMENTATION PAYERS COMMONLY ASK FOR
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MRI
for example CPT 72148, lumbar spine without contrast
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Advanced imaging that insurers review closely, often through a radiology benefit manager
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Symptom duration, failed conservative treatment, prior imaging, diagnosis codes
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CT scans
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High-cost imaging with frequency and appropriateness criteria
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Clinical indication, prior studies, relevant labs
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PET and PET-CT
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Costly scans, common in cancer staging
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Nuclear medicine and other advanced imaging
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Treated as advanced imaging by many plans
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Ordering provider details, indication, prior results
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Rules change by payer and plan, so Notove checks the payer’s requirements for every order instead of relying on a static list.
Who owns the authorization: the ordering provider or your center?
It depends on the plan. Many payers expect the ordering provider to request approval. Many also expect the center performing the scan to confirm it before the appointment, and may deny the claim if no approval exists.
The safest workflow checks at scheduling
One verification step before the slot is booked protects your schedule, your revenue and the patient’s time. Notove runs it automatically when the order arrives.
A scheduling-time check
- Confirm whether the order’s CPT code needs approval under the patient’s plan.
- Confirm an approval is on file, or start the request before booking.
- Track the decision and reschedule early if it is denied or still pending.
How Notove handles imaging authorizations
Notove handles the repetitive work between the imaging order and the payer’s decision. Your staff stay in control of every submission.
1. Authorization Detected
The patient arrives, the approval is missing and the slot is lost. Your scanner sits idle while the patient waits for a new date.
2. Documentation Collection
The AI gathers clinical notes, prior imaging, the problem list and failed conservative treatment from the EHR, the electronic health record where patient charts live.
3. Request Preparation
Notove prepares the payer-specific request and checks it against the payer’s requirements before anyone submits.
4. Staff Review and Submit
Your authorization specialist reviews the draft and submits in seconds. Nothing goes out without staff approval.
5. Submission Tracking
Follow every request from submitted to pending to approved or denied, with alerts so the schedule can adjust early.
Fits your current setup
Notove works alongside your existing systems and runs in the browser. Integration options vary by workflow and are reviewed during onboarding.
What changes for your scheduling team
Fewer reschedules
Approval status is clear before the appointment, so patients arrive to a confirmed scan.
Fewer post-scan denials
Complete, payer-specific requests reduce the missing details that send requests backward.
Less time on the phone
Your team reviews prepared drafts instead of building each request from scratch and chasing updates.
Understanding radiology benefit managers
Many insurers hand imaging approvals to a radiology benefit manager (RBM), a company hired to review advanced imaging requests. eviCore and Evolent, formerly known as National Imaging Associates, are two examples. Each has its own forms, clinical criteria and portal, so rules differ between payers even for the same scan. Notove prepares payer-specific requests, so your team does not have to relearn each reviewer’s format.
Frequently Asked Questions
It depends on the payer. In many plans the ordering provider requests approval, while the center performing the scan must confirm it exists before the appointment. If neither side checks, the claim can be denied. A scheduling-time verification step closes that gap.
Payers commonly ask for the clinical indication, symptom duration, results of conservative treatment such as physical therapy or medication, any prior imaging and the diagnosis codes. Notove gathers these from the chart and flags anything missing before the request goes out.
Check the order’s CPT code against the patient’s plan rules, then confirm an approval is on file or start the request before booking. Notove automates this check when the order arrives and shows the status in one place.
The payer may deny the claim, and the center can end up absorbing the cost of the scan. Some plans allow a retrospective review, but outcomes vary. Confirming approval before the appointment avoids that risk.
Many commercial and Medicare Advantage plans use benefit managers such as eviCore or Evolent for advanced imaging, but the arrangement differs by plan and state. Check each payer’s provider portal, or let Notove check requirements for each order.
It varies by payer and urgency. Since January 2026, many Medicare Advantage, Medicaid and marketplace plans must decide standard requests within seven calendar days and expedited ones within 72 hours. Submitting complete requests early lets the decision arrive before the appointment.