Nia imaging. com under Online Tools/Clinical Guidelines.
Nia imaging. This program is a radiology and imaging benefit management program for non-emergent, advanced, outpatient radiology services designed to ensure clinically appropriate care. 1— Home State Health and Allwell from Home State Health - Frequently Asked Questions – Physical Medicine Services External Use – 03. (NIA) 1, to implement the following Medical Specialty Solutions Programs: Interventional Pain Management National Imaging Associates, Inc. The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups National Imaging Associates, Inc. In 2006, NIA was National Imaging Associates (NIA) Arkansas Health & Wellness has contracted with National Imaging Associates Inc. (“Evolent”). Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource. Guideline Development Process These medical necessity criteria were developed by National Imaging Associates, Inc. Mar 7, 2024 · New Century Health and National Imaging Associates are now Evolent! Date: 03/07/24 As you may be aware, Ambetter of North Carolina Inc. ” Partial-Unicompartmental Knee Arthroplasty (UKA) NIA’s Clinical Guidelines can be found on NIA’s website, www. (NIA) is a subsidiary of Magellan Healthcare, Inc. (NIA) provides utilization management services for non-emergent, outpatient Medical Specialty Solutions services for Wellcare Medicare membership in the State of Mississippi. Evolent Clinical Guidelines are available on RadMD. Primarily designed for Imaging Facilities, Hospitals and Health Plans, logging on to RadMD can provide up-to-the-hour information on a member's authorization, including date called, date approved NIA’s guidelines are reviewed yearly and modified when necessary following a literature search of pertinent and established clinical guidelines and accepted diagnostic imaging practices. RadMD is a user-friendly, real-time alternative or supplement to our call center. In addition to the services that currently require prior authorization through NIA, certain cardiac-related procedures will also require prior authorization beginning November 1, 2022. Providers may begin contacting RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Information required includes: • Name and office phone number of ordering provider* • Member name and ID number* • Requested examination* The “Track an Authorization” feature will allow users who did not submit the original request to view the status of an authorization, as well as upload clinical information. To expedite the process, please have the following information ready before logging on to https://www. Effective 1/20/2023, National Imaging Associates, Inc. 1, 2024, New Century Health and NIA are now Evolent Specialty Services, Inc. A tracking number is required with this feature. Who can a provider contact at NIA for more information? You may contact your dedicated NIA Provider Relations Manager: Gina Braswell OTR/L 1-952-225-5726 gbraswell@evolent. What information does NIA require before a medical necessity review can be initiated for prior authorization determination? Radiation Oncologist should have all of the following informati n available before logging on to NIA’s website, https://www. Have the appropriate information ready before logging into NIA’s Website or calling NIA’s Call Center at 1-888-642-4814. Feb 22, 2022 · Discontinuation of NIA Peer-To-Peer Telephone Number Date: 02/22/22 Dear Provider: Following a comprehensive assessment of our business processes, National Imaging Associates, Inc. As of Jan. NIA’s guidelines for the use of imaging examinations have been developed from practice experience, literature reviews, specialty criteria sets and empirical data. Evolent Health, formerly National Imaging Associates, Inc. com) or by calling NIA at 1-866500-7664. Please contact Wellcare for authorization requests in an inpatient setting. com or calling the Evolent (formerly National Imaging Associates, Inc. NIA’s guidelines are reviewed yearly and modified when necessary following a literature search of pertinent and established clinical guidelines and accepted diagnostic imaging practices. Feb 1, 2022 · What information is required to receive prior authorization? Specialty Solution. partners with New Century Health (NCH) and National Imaging Associates (NIA) for the utilization management of certain services (see list below). (NIA)1 to implement the following Medical Specialty Solutions Programs: Radiology Benefit Management Who is National Imaging Associates Founded in 1995, National Imaging Associates (NIA), pioneered the radiology benefits management industry. , a Magellan Healthcare Company, to implement a new prior authorization program to manage outpatient (office and hospital) habilitative and rehabilitative physical medicine services, including services rendered in the home, effective on October 1, 2019. National Imaging Associates, What to expect when calling in for a peer-to-peer peer-to-peer discussion may be initiated at any time during the prior-authorization process by calling 1--800-424-4915. RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. (NIA)1 Musculoskeletal Care Management (MSK) Program Frequently Asked Questions (FAQ’s) For PA Health & Wellness Physicians/Surgeons Beginning October 1, 2021, Fidelis Care is pleased to announce our expanded partnership with National Imaging Associates, Inc. The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups Guideline Development Process These medical necessity criteria were developed by National Imaging Associates, Inc. These criteria are supported by evidence-based or peer-reviewed sources such as medical literature, societal guidelines and state/national recommendations. RadMD. If an urgent/emergent clinical situation exists outside NIA’s guidelines for the use of imaging examinations have been developed from practice experience, literature reviews, specialty criteria sets, and empirical data. com or by calling the NIA toll-free number 1-888-642-2583. Where a specific clinical indication is not directly addressed in this guideline, medical necessity determination will be made based on widely accepted standard of care criteria. This name Guideline Development Process These medical necessity criteria were developed by National Imaging Associates, Inc. May 27, 2021 · May 27, 2021 In keeping with our commitment of promoting continuous quality improvement for services provided to WellCare of North Carolina members, WellCare of North Carolina has entered into an agreement with National Imaging Associates, Inc. The following non-emergent, outpatient, Medical Specialty Solutions services require prior authorization through NIA: Emergency room/urgent care facility, observation and inpatient procedures do not require prior authorization from NIA. (NIA) would like to inform you that our peer-to-peer review phone number will be changing. (NIA) for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures. Primarily designed for Imaging Facilities, Hospitals and Health Plans, logging on to RadMD can provide up-to-the-hour information on a member's authorization, including date called, date approved, exam category, valid billing codes (CPT) and much more. Keystone First has an agreement with Evolent (formerly National Imaging Services [NIA]) to manage diagnostic imaging services such as MR/CT/PET. When a procedure is authorized, NIA will use the date of the initial request as the starting point for the 60-day period in which the examination must be completed. Imaging can assist in the diagnosis of TMD when history and physical examination findings are equivocal. Authorizations through NIA are required for inpatient Musculoskeletal Surgeries and Sleep Assessments. These medical necessity criteria were developed by National Imaging Associates, Inc. Information required includes: • Name and office phone number of ordering provider* • Member name and ID number* • Requested examination* RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. What does the NIA authorization number look like? an NIA tracking number (not the same as an authorization number) if the provider’s authorization request is not approved at the time of in tial contact. com, click the New User button and submit a “RadMD Application for New The following non-emergent, outpatient, Medical Specialty Solutions services require prior authorization through NIA: Emergency room/urgent care facility, observation and inpatient procedures do not require prior authorization from NIA. As of March 1, 2022, the phone number: 1-888-642-7649 will be discontinued. Learn more. If an urgent/emergent emergency clinical situation exists outside of a hospital emergency room, please contact NIA immediately with the appropriate clinical information for an expedited review. com. (NIA) to provide utilization management for Radiation Oncology services and non-emergent, radiology outpatient Medical Specialty Solutions procedures for Fidelis Care members with Medicare, Medicaid, and Qualified Health plans. Our system provides instant access to much of the prior authorization information that our call center staff provides. com or by When should requests for medical necessity review be submitted? How does the ordering provider obtain a prior authorization from NIA for a Medical Specialty Solutions outpatient service? Providers can request prior authorization via the internet (RadMD. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. If an urgent/emergent clinical situation exists outside of a hospital emergency room/urgent care, please contact NIA immediately with the appropriate clinical May 27, 2021 · May 27, 2021 In keeping with our commitment of promoting continuous quality improvement for services provided to WellCare of North Carolina members, WellCare of North Carolina has entered into an agreement with National Imaging Associates, Inc. With our long-standing experience, ground ed in clinical research, innovative technology and proven results, NIA has grown to become a proven specialist in offering medical specialty solutions to effectively manage quality and cost. (NIA)1 to implement the following Medical Specialty Solutions Programs: Radiology Benefit Management (RBM) Cardiac Imaging Interventional Pain National Imaging Associates (NIA) has partnered with Magnolia Health Plan (Magnolia) (under the contract of the Mississippi Division of Medicaid) to provide radiology network management services to members through the Medicaid MississippiCan program. The program will require prior authorization from Evolent for nonemergent outpatient: CT/CTA CCTA MRI/MRA PET scan MUGA scan Myocardial perfusion imaging (MPI) Providers can request prior authorization online or by calling Evolent at 1-800-642-2602 National Imaging Associates, Inc. com or call 1-800-327- 0641. Aug 30, 2022 · National Imaging Associates (NIA) Expansion Date: 08/30/22 Absolute Total Care is pleased to announce the expansion of its partnership with National Imaging Associates, Inc. com* under Online Tools/Clinical Guidelines. 11. (NIA). com NIA’s Clinical Guidelines are on RadMD. To ensure prompt receipt of your information: *Using n incorrect fax coversheet may delay a response to an authorization request What information should you have available when obtaining an authorization? How will I confirm physical medicine benefits for a member? Emergency room and inpatient imaging procedures do not require prior authorization from NIA. Emergency room and inpatient imaging procedures do not require prior authorization from NIA. This name The following non-emergent, outpatient, Medical Specialty Solutions services require prior authorization through NIA: • CT/CTA • MRI/MRA • PET Scan • MUGA • CCTA • Myocardial Perfusion Imaging (MPI) • Echocardiography • Stress Echocardiography • Interventional Pain Management • Inpatient and Outpatient Musculoskeletal Surgeries - Effective July 1, 2023 • Physical Medicine National Imaging Associates, Inc. NIA’s guidelines for Medical Specialty Solutions services were developed from practice experience, literature reviews, specialty criteria sets and empirical data. To get started, simply go to www. NIA will begin accepting authorization requests on September 20, 2021 for services rendered on or after October 1, 2021. (NIA) Medical Specialty Solutions Frequently Asked Questions (FAQ’s) For CareSource PASSE Providers on for your practice, you may fax utilizing the NIA specific fax coversheet. You have instant access to the imaging authorization and supporting information you need on this site. NIA will provide utilization management services for outpatient MR, CT, CCTA, PET, Nuclear Cardiology/MPI, Stress Echocardiography, and For evaluation of suspected intracranial vascular disease2, 3 National Imaging Associates, Inc. This option is also available as a part of your main menu options using the “Search by Tracking Number” feature. Yes, through our shared access process. Medical Specialty Solutions Quick Reference Guide for ordering and rendering providers Effective: May 1, 2022 Blue Cross Complete has entered into an agreement with National Imaging Associates Inc. Providers can use either number to track the status of their request authorization through RadMD and the request pends, what happens The authorization number is valid for 60 days from the date of request. RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Whether submitting imaging exam requests or checking the status RadMDSupport@evolent. (NIA) Medical Specialty Solutions Frequently Asked Questions (FAQ’s) For QualChoice Health Insurance Providers Jul 8, 2021 · July 8, 2021 Dear Provider, Thank you for your valued partnership. Medical necessity determinations are based on Evolent Clinical Guidelines. 2019 Sunshine Health has contracted with Evolent* for radiology and cardiac imaging benefit management. com under Online Tools/Clinical Guidelines. In keeping with our commitment of promoting continuous quality improvement for services provided to WellCare of New Jersey (WellCare) members, WellCare has entered into an agreement with National Imaging Associates, Inc. This process AmeriHealth Caritas Next has an agreement with Evolent, formerly National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management. Evolent Health and its affiliates and subsidiaries collectively referred to as “Evolent. “NIA”) Utilization Management staff. National Imaging Associates, Inc. (NIA)* Musculoskeletal Care Management (MSK) Program Frequently Asked Questions (FAQ’s) For Blue Shield of California (Blue Shield) Ordering Physicians/Surgeons NIA at 1-888-642-7649 to request a fax coversheet online or during the initial phone call NIA may fax this coversheet to the Physical Medicine Practitioner during authorization intake or at any time during the review process. *Using an incorrect fax coversheet may delay a response to an authorization request. . What information is required to receive prior authorization? Ordering Physicians will be able to request prior authorization via the NIA website https://www. Aug 5, 2019 · Fidelis Care has engaged National Imaging Associates, Inc. The initial study should be plain radiography (transcranial and transmaxillary views) or panoramic radiography when there is recent trauma, dislocation, malocclusion, or dental infection. SilverSummit Healthplan has contracted with National Imaging Associates (NIA), an affiliate of Magellan Health Services, for radiology benefit management. RadMD is available 24/7, except when maintenance is performed every third Thursday of the month from 9 pm – midnight PST. is now a subsidiary of Evolent Health. , a subsidiary of Evolent Health LLC, to manage a suite of Medical Specialty Solutions. Implementation will be October 1, 2021. (NIA), to manage diagnostic imaging services such as MR/CT/PET. zgkrksjpdbw5bxpd6l1glybgimllom8whwcjkjy8gnc