High-tech imaging costs are now a major factor driving up the cost of health care. To help make sure that the type of technology chosen matches the type that's needed, BlueCross BlueShield of Tennessee is asking doctors and hospitals to use a prior authorization process.

For Members in Fully Insured Health Plans

Starting August 1, 2006, any time a doctor in Blue Network P or S recommends an outpatient MRI or other high-tech imaging test, the test or procedure must be authorized in advance. No authorization is needed for the tests in an emergency or as part of an inpatient hospital treatment plan.

The types of high-tech imaging services included are magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), magnetic resonance spectroscopy (MRS), computed tomography (CT scans), computed tomography angiography (CTA scans), positron emission tomography (PET scans), and nuclear cardiology.

If a Blue Network doctor suggests one of these outpatient procedures, it's important to know that:

You will be "held harmless" if your Blue Network doctors don't get a prior authorization. The company will not reimburse the providers, and the providers cannot bill you for the charges.

Out-of-state and out-of-network doctors are not required to get prior authorization for high-tech imaging tests. Neither are you when using out-of-state or out-of-network providers. But, remember your coverage's limitations and exclusions still apply, and you will pay more of the cost if you use out-of-network providers.