When Your Doctor Orders Imaging: Understanding the Referral Process

Your doctor says, "I am ordering an MRI for you." You nod, leave the office, and then think: wait — what do I do now? Where do I go? Do I need to call someone? Does insurance need to approve it?

Here is how the process works, step by step.

Step 1: The Order

Your physician writes an imaging order (also called a referral or prescription). This includes: - Your name and date of birth - The type of exam (e.g., "MRI of the left knee without contrast") - The clinical reason (e.g., "persistent knee pain, rule out meniscal tear") - Whether contrast is needed - Any special instructions

This order is sent electronically to the imaging center or given to you as a printed document.

Step 2: Insurance Authorization

This is the step that confuses most patients.

Many insurance plans require prior authorization as defined by CMS for advanced imaging (MRI, CT scan, PET). This means your insurance company must approve the exam before it is performed. Authorization confirms that the exam is medically necessary based on your symptoms and clinical history.

Who Handles Authorization? - Your doctor's office typically initiates the authorization request - The imaging center may also handle it (at AMI, we assist with this process) - You may need to provide your insurance card and demographic information

How Long Does It Take? - Same day to 3-5 business days depending on the insurance plan - Some plans have automated portals (instant approval) - Others require clinical review (may take longer) - Emergency exams do not require prior authorization

What If Authorization Is Denied? A denial does not mean you cannot have the exam. It means the insurance company wants more information. Your doctor can: - Submit additional clinical documentation - File a peer-to-peer review (your doctor speaks directly with the insurance company's medical director) - Appeal the decision

Exams That Usually Do NOT Need Authorization - X-rays - Screening mammograms - Basic ultrasounds - DEXA scans

Step 3: Scheduling

Once authorization is obtained (or if none is needed), you schedule the exam.

At AMI, scheduling is easy: - Call (727) 398-5999 - Online: Request an appointment and we will call you back - Fax: Your doctor's office can fax the order to (727) 231-0772

We offer same-day and next-day appointments for most exams. No weeks-long wait times.

What to Have Ready When You Call - Your name, date of birth, and phone number - Insurance card (front and back) - Referring physician's name - Type of exam ordered - Authorization number (if you have it)

Step 4: Before Your Exam

We will provide specific preparation instructions based on your exam: - MRI: Remove all metal; wear comfortable clothing - CT with contrast: You may need to fast; inform us of kidney issues or allergies - Ultrasound (abdominal): Fast for 8-12 hours - Pelvic ultrasound: Full bladder required - DEXA: No preparation needed - Mammogram: No deodorant, lotion, or powder on exam day - X-ray: No preparation needed

Arrive 15 minutes early to complete paperwork.

Step 5: The Exam

Exams range from 5 minutes (X-ray) to 45 minutes (MRI). Our technologists will explain everything before the exam begins and answer any questions.

Step 6: Results

Our board-certified radiologist reviews your images and writes a detailed report. This report is sent to your referring physician, typically within 48 hours. Stat (urgent) reads are available.

Your doctor will contact you to discuss the results and any next steps. You can also access your results through your doctor's patient portal.

Self-Referral: When You Do NOT Need a Doctor's Order

In Florida, certain exams can be self-referred (no physician order needed): - Screening mammograms (age 40+) - Some wellness screenings

For all other exams, a physician referral is required. This is both an insurance requirement and a medical safety measure — the ordering physician ensures the right exam is ordered for the right reason.

Self-Pay Patients

No insurance? No problem. AMI offers transparent self-pay pricing that is typically 60-75% less than hospital pricing. No referral authorization is needed — but you still need a physician order for the exam.

Visit our pricing page for details.

Making It Easy

At AMI, we believe getting the imaging you need should not be stressful or complicated. We handle insurance authorization, offer flexible scheduling, provide results quickly, and keep our pricing transparent.

Call (727) 398-5999 or schedule online. We will take it from there.