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Imaging Denial

Molina Healthcare Denied Your CT Scan?

According to federal data, Molina Healthcare Inc. denies approximately 21% of claims. When patients appeal, about 42% are overturned. Your ct scan denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.

21%
Denial Rate
42%
Appeal Success
30-45 days
Typical Timeline
$1,000–$5,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why Molina Healthcare Denies CT Scan

Not medically necessary based on clinical criteria

MRI recommended instead of CT

Prior imaging not attempted first

Molina Healthcare's Common Denial Tactics

Denying specialist referrals as not medically necessary

Applying Medicaid criteria to marketplace plans

Delays in prior authorization processing

How to Win Your CT Scan Appeal

Physician order with clinical indication

Evidence that CT is more appropriate than MRI for the condition

ACR Appropriateness Criteria supporting CT for diagnosis

Laws That Protect You

ACA — Preventive screening requirements

State imaging parity laws

Emergency prudent layperson standard

Tips for Appealing to Molina Healthcare

Molina serves many Medicaid/marketplace enrollees — cite state Medicaid rules if applicable

File a complaint with your state Medicaid agency for Medicaid-managed care plans

Request expedited review if treatment is urgent

Ready to Review Your CT Scan Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in Molina Healthcare's reasoning and outline your appeal options.

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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.

Molina Healthcare Denied Your CT Scan? Here's How to Appeal | Lysco