TO: EXTERNAL REFERRING PHYSICIANS FROM: MUSCULOSKELETAL RADIOLOGY JOHNS HOPKINS MEDICINE DATE: JUNE 2, 2010 RE: AUTHORIZATIONS FOR PATIENT EXAMS AT HOPKINS We thank you for referring your patients to us. Please note that all carved out products require authorization, primary and secondary insurances. This includes and is not limited to carved out insurances that are secondary to Medicare, all Aetna Products of the Mid-Atlantic States, Blue Choice, Kaiser Permanente of the Mid-Atlantic States, and all other carved out insurances such as HMOs and MCOs. We are happy to facilitate this for you; however, at the time of scheduling, the following MUST be sent to us (fax# 410-502-6454) before the exam can be scheduled: - All Medical Records pertinent to the patient’s requested exam:
o Prior tests related to request o Clinic notes/documentation o Treatment period, patient history and diagnosis o Reason for test; explain if this is an urgent/emergent or elective request - Your MD Tax ID number
- Authorization (signed by the patient) to Release their Medical Records to us.
Thank you for your cooperation. | 
