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. 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. 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.
Who can a provider contact at nia for more information You may contact your dedicated nia provider relations manager 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 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?
We strongly recommend using radmd to request a prior authorization If you do need to call, please use the phone number that has been designated for your evolent prior authorizations That number can be found on radmd and may vary according to the member’s health plan 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.
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