For Physicians and Providers

New! Radiology Scheduling Manual!

Now you can download everything you need to know to order tests and procedures, contact information, locations and hours of operation - right to your desktop. Simply click the link below and save this convenient document to your computer.

Download the Radiology Manual

Requesting Radiology Procedures & Referrals

Only medical physicians and chiropractors are authorized to order radiology procedures. Physician assistants and nurse practitioners credentialed by Middlesex Hospital are also authorized to order radiology exams.

Patient self-referrals are only allowed for screening CT colonoscopy and screening mammography.

All orders for a Radiology procedure must have a signed written order by an authorized provider. Radiology procedures will not be scheduled or performed without a signed written order.

In order to schedule patients, in a manner which expedites those cases needing immediate care, please indicate the priority in the following way:

ROUTINE: Fax completed FAX ORDER to Appointment Scheduling.
URGENT - within 24 hours: Call site where you want to have the procedure performed for an appointment time, and fax completed order as directed, by department.
STAT – immediate attention: Call site where you want to have the procedure performed for an appointment time, and fax completed order as directed, by department.

STAT and URGENT cases should be called directly to the Middlesex Hospital facility and imaging modality where you want the patient to have the procedure. The technologist can provide the best time to fit the patient into the existing schedule.

Procedure for routine scheduling

Fill out, completely, the FAX ORDER form, indicating appropriate exam type, medical history, diagnosis, and other information, such as insurance / pre-cert number, as needed.

Orders with incomplete or unreadable information will be returned for correction and will delay processing. All orders will be screened for medical necessity and may be returned unscheduled if either the procedure or the reason for the procedure is not covered by Medicare or other carriers.

A pre-certification number is required for procedures as indicated by the patient’s insurance carrier. Procedures will not be scheduled until the pre-cert number is provided.

Indicate the patient’s preference as to the day(s) and time of day most convenient for the patient. Not providing this information inconveniences your patients and generates many calls to the department for rescheduling.

Indicate whether:

patient waiting,
office will call patient,
patient given instructions – call patient (Scheduling will call).

Tear off the top page and FAX TO 860-358-2626 – Central Appointment Scheduling

The back of the second page of the fax order form should be checked for the facility where the procedure will be performed and the procedure prep and should be given to the patient to bring with them for their appointment.

Middlesex Hospital appointment scheduling will take the completed faxed order form from the fax unit and an appointment will be scheduled, in the order of receipt. Appointment confirmation will be auto-faxed to the referring physician office.

Orders sent indicating “patients waiting” are handled first, for the fastest response. The scheduler will auto-fax the confirmation and call the office, with the appointment date and time, if able to get through to office. Incomplete orders delay this process.

Patients needing to reschedule should call Middlesex Hospital Appointment Scheduling to change their appointment date or time. We will then notify the referring physician office of the change.

Middlesex Hospital
860-344-6293

Middlesex Outpatient Center
860-358-2500

Shoreline Medical Center (Essex)
860-358-3810

Marlborough Medical Center
860-358-3050