This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services. NIA may request clinical documentation to support the medical necessity and appropriateness of the care. An authorization number is not a guarantee of payment. Prior authorization is required for the following outpatient radiology procedures: Authorizations are valid for 60 days from the date of the initial request.
RadMD: Online Access to NIA Service. RadMD is a user-friendly, real-time alternative or supplement to the NIA Call Center.
The Internet-based system provides. Powered by NIA (National Imaging Associates), RadMD offers providers and contracted health plans a wealth of powerful resources and information.
To obtain. The following authorization tools are available after you log in: NIA Magellan does not reward through financial incentives practitioners or other individuals for .
For cardiac services, include total cholesterol, ECG results, HDL level, problems with exercise capacity and results of previous cardiac evaluation procedures e.
National Imaging Associates (NIA) IlliniCare Health
NIA reviews are not required for:. Prior authorization is required for the following outpatient radiology procedures: You will be able to upload requested records on the NIA website www. Those requests must be processed by calling NIA at: Authorization status for a provider's patients can also be checked on-line at the NIA website.
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|If requested records are not received, claims will be denied due to lack of information.
Please verify member benefits and eligibility by visiting our web site or calling Coordinated Care Provider Services at If you have questions, please contact Coordinated Care Provider Services at The rendering facility or provider must verify that prior authorization was obtained prior to rendering the service.
Blue Shield reserves the right to revoke authorizations prior to services being rendered based on cancellation of the member's eligibility.
Video: Nia radmd login Imaging Order Prior Auth Workflow
Website, the national NIA Magellan Imaging Provider Handbook. ?leftmenu=1&sub=child1_1 after imaging facility login on NIA Magellan's.
National Imaging Associates (NIA) Outpatient Radiology Authorization
RadMD is a user-friendly, real-time tool offered by National Imaging Associates, Inc. (NIA) that provides you with instant access to the high-tech imaging authorization and supporting Your RadMD login information should not be shared.
Physical exam findings including findings applicable to the requested services, e.
An authorization number is not a guarantee of payment.
Services Reviewed Outpatient non-emergency advanced imaging examinations of the following types are reviewed: Log in to continue with member verification. NIA may request clinical documentation to support the medical necessity and appropriateness of the care. Details justifying the examination.
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|The following non-emergent, advanced, outpatient imaging procedures require prior authorization through NIA:. The NIA website cannot be used for retrospective or expedited authorization requests.
National Imaging Associates (NIA) Coordinated Care
The following services do not require authorization through NIA: RadMD is available 24 hours per day, seven days per week, except when maintenance is. NIA Magellan is experienced in the field of radiology management and has a client to meet HMSA's needs are available for reference (see ) .
If you haven't registered on the Blue Shield website, you will need to register before logging in.
Medical necessity denials can be appealed through NIA. NIA reviews are not required for:. Home Find a Doctor Login Contact.
NIA reviews are not required for:
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|Outpatient non-emergency advanced imaging examinations of the following types are reviewed:. Reason the study is being requested e. NIAprovides utilization management review and authorization for non-emergent, advanced, outpatient imaging procedures.
Member name and ID number. All other claims appeals are processed through the health plan. X-rays, CTs, lab work, ultrasound, scoped procedures, referrals to specialist and specialist evaluation.