Magnetic Resonance Imaging (MRI) is a diagnostic tool that creates detailed images of organs and tissues using a powerful magnetic field and radio waves, without the use of ionizing radiation. The process involves coordination between your physician, the imaging center, and your insurance provider. This guidance details the necessary steps to secure your MRI appointment efficiently.
Understanding the Required Medical Referral
A patient cannot typically schedule an MRI without a formal medical order, as the procedure requires documented justification to ensure medical necessity. This order, often called a prescription or referral, must be issued by a licensed healthcare provider, such as a primary care physician or a specialist. The physician evaluates your symptoms and medical history to determine the precise anatomical area and specific type of scan required.
The referral serves as the foundational document, providing the imaging center and insurance company with a diagnosis code and procedure code. This documentation is necessary for the imaging center to understand the medical question the scan is intended to answer. In most cases, this referral must be sent directly from the ordering doctor’s office to the intended imaging facility.
Navigating Insurance Coverage and Facility Choice
Once the medical order is in place, securing financial authorization from your insurance company is the next step, which usually involves a pre-authorization or pre-certification process. Insurance providers require this step to confirm the scan is medically necessary and meets the terms of your specific policy before they agree to cover the cost. The imaging facility’s billing department often handles the submission of the necessary documents, but the process can take several days to a week depending on the insurer.
It is highly recommended to verify that the chosen imaging facility is considered “in-network” with your health plan to prevent significantly higher out-of-pocket costs. Facilities vary, from hospital-based centers to independent outpatient imaging centers, and their cost structures may differ substantially. You should also inquire about the type of MRI equipment available, such as a 1.5 Tesla (T) or 3T scanner, as 3T scanners offer higher resolution images.
What to Expect During the Scheduling Call
After the insurance authorization is secured, the imaging center will contact you to schedule the appointment and confirm logistics. The scheduler will need to confirm your patient demographics, insurance ID number, and the specific referral order to ensure all paperwork matches the authorized procedure. You should also confirm the exact type of scan, specifically whether it includes contrast material, which is an intravenous injection that enhances the visibility of certain tissues or blood vessels.
You should use this call to discuss any concerns, such as claustrophobia, and ask about options like an open MRI machine or a mild sedative. Confirm the expected duration of the scan, which can range from 20 minutes to over an hour depending on the complexity of the exam. Finally, get the precise location, parking information, and the recommended time you should arrive before the scan, which is typically 15 to 30 minutes for screening and preparation.
Preparing for the Day of the Scan
Preparation for the MRI focuses heavily on safety due to the powerful magnet used by the scanner. You will be asked to remove all metal objects, including jewelry, watches, hairpins, and any clothing with metallic threads, zippers, or snaps. Patients with implanted medical devices, such as pacemakers, neurostimulators, or aneurysm clips, must notify the facility and may be required to bring device cards to ensure the implant is safe for the magnetic field.
Dietary restrictions are generally minimal unless you are receiving sedation or having an abdominal or pelvic scan, in which case you may be asked to fast for four to six hours beforehand. You should continue to take your regular medications unless specifically instructed otherwise by your doctor or the imaging center. On the day of the appointment, bring your photo identification, insurance card, and any forms that were mailed to you to facilitate the final check-in and screening process.