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Our system provides instant access to much of the prior authorization information that our call center staff provides

You have instant access to the imaging authorization and supporting information you need on this site Whether submitting imaging exam requests or checking the status. These medical necessity criteria were developed by national imaging associates, inc (nia) for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures. Nia’s clinical guidelines are on radmd.com* under online tools/clinical guidelines Nia’s guidelines for medical specialty solutions services were developed from practice experience, literature reviews, specialty criteria sets and empirical data.

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. Who can a provider contact at nia for more information You may contact your dedicated nia provider relations manager These medical necessity criteria were developed by evolent for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups Evolent’s guidelines are reviewed yearly and modified when.

How does the ordering provider obtain a prior authorization from nia for a medical specialty solutions outpatient service

What information is required to receive prior authorization? Evolent offers a variety of helpful tools and educational resources for your use See the list at the left of this page Please log into radmd to access the call. Clinical guidelines preview 2026 advanced imaging guidelines 2025 advanced imaging guidelines checklists advanced imaging checklist low dose chest ct history form tip. The policies constitute only the reimbursement and coverage guidelines of nia

Coverage for services varies for individual members in accordance with the terms and conditions of applicable certific tes of coverage, summary plan descriptions, or contracts with governing regulatory You can access our clinical guidelines, checklists and other tools for each solution below Advanced imaging cardiac genetic testing interventional pain management musculoskeletal surgery physical medicine radiation oncology sleep for health plan specific clinical guidelines, cms guidelines that include local and national coverage determinations (lcds and ncds), educational documents and other.