When calling an insurance company to schedule a magnetic resonance imaging (MRI) test, what is the nurse obtaining?

When the nurse is calling an insurance company to schedule a magnetic resonance imaging (MRI) test, they are typically obtaining precertification. This process involves confirming that the insurance company approves the MRI as a medically necessary procedure before it is performed. Precertification is essential in ensuring that the patient’s insurance will cover the costs associated with the MRI, thereby preventing unexpected expenses for the patient.

It is important for nurses to be aware of precertification requirements specific to different insurance policies, as these can vary. The precertification process can involve submitting necessary medical documents or referrals to validate the need for the MRI, which is why contacting the insurance company is a crucial step in facilitating the patient's care and treatment plan.