It is a “smart” application which only will ask you questions that apply directly to your practice, based on the previous responses you provided. Log into your account, view patient information, and more. Radiology Precertification . Simply go to the RadMD website, select "New User" button and complete the application form. Prior Authorization and Notification Process . Reconsideration Form. Authorizations. Grievance Reporting Form. Whether submitting imaging exam requests or checking the status of ordered exams, you will find RadMD to be an efficient, easy-to-navigate resource. ©1999-2020 Magellan Health, Inc. ALL_RIGHTS_RESERVED. Many services do not require pre-authorization, but before providing care we request that you confirm the prescribed service is covered under Member’s benefit plan by contacting our Provider Service Center or by logging in with your provider credentials here and checking coverage in our new prior-authorization web page. We’ve designed the documents in this section to support you in your quality care of Magellan members. *The NIA Call Center and *www.RadMD.com will be available beginning September 23, 2019, for prior authorization for dates of service October 1, 2019 and beyond. WHICH MEDICAL PROVIDERS ARE AFFECTED? Absolute Total Care has contracted with National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health Services to provide utilization management for outpatient rehabilitative and habilitative physical medicine services. Magnolia Health has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management..       New Account by selecting “Physical Medicine Practitioner.”  Your RadMD login information should not be If services require precertification through NIA, you will be prompted to contact them for precertification. You simply file your claim and respond to any outreach calls from a Magellan care advocate, should such occur. NIA is an affiliate of Magellan Health Services . View a provider orientation (PDF) to our outpatient model. •    Medicaid Managed Care (NYM)     You can also check the status of your authorization by contacting the phone number on the back of your ID card. The service requires precertification through another entity (like National Imaging Associates or NIA). The exact date of service is not required, with the exception of Interventional Pain Management. Fidelis Care has engaged National Imaging Associates, Inc., 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, Inc. (NIA) Authorization Program Beginning October 1, 2019, 8/5/2019 • •    Fidelis Care at Home (FCAH - managed long term care) Posted by Provider Relations, FIDELIS CARE is a trademark of Centene Corporation, Important Updates Regarding Coronavirus COVID-19, National Imaging Associates Provider Notice, Fidelis Care Physical Medicine Prior Authorization Quick Reference Guide for Providers, Frequently Asked Questions – Fidelis Care Physical Medicine Services Prior Authorization. The system is fast and easy to use and ensures accuracy. ... Services Managed by NIA Magellan … To submit prior authorization request types, use the Fidelis Care provider portal. Buckeye Health Plan has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.. If you have any questions about coverage and whether pre-authorization is necessary for the service you are providing, contact us at the number on the member’s benefit card. NIA is an independent Further details regarding this new prior authorization program can be found by viewing the resource links below. Inpatient Discharge Checklist Added 04-27-15. EAP ; Administrative ; Clinical RadMD is a user-friendly, real-time automated tool that gives instant access to advanced imaging, cardiac, physical medicine and other specialty procedure authorizations. You simply file your claim and respond to any outreach calls from a Magellan care advocate, should such occur. The CVR process will include the request and review of clinical information by NIA. This link leads to a third party site. 3. For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review. MHS has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management. When an authorization of care is required, our philosophy is to base authorization on a thorough assessment of the member’s unique needs to be delivered at the least-intrusive appropriate level, and to do so in a timely and efficient manner. Fidelis Care has engaged National Imaging Associates, Inc., 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. We work with National Imaging Associates (NIA) Magellan Healthcare to manage radiology prior authorizations on behalf of BlueCross BlueShield of South Carolina. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. •    There are two preferred ways to submit prior authorization -- either through the NIA website at      Effective Oct. 3, 2016, Highmark has implemented a Clinical Validation of Records (CVR) process for all codes that are part of the Radiology Management Program. This program is consistent with industry-wide efforts to manage the increasing utilization of these services and to ensure quality of care. All providers will be required to obtain prior authorization for physical medicine services, which includes physical therapy, occupational therapy, and speech therapy. (NIA) that provides you with instant access to the high-tech imaging authorization and supporting information you need, in an easily accessible Internet format. NIA Magellan is responsible for managing the precertification of all advanced imaging scans. If requesting authorization through NIA’s website and your request is pended, you will receive a tracking number, and NIA will contact you to complete the process. Screening, Brief Intervention, and Referral to Treatment (SBIRT). Services That Require Prior Authorization All services that require prior authorization from CareSource should be authorized before the service is delivered. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. You have instant access to the imaging authorization and supporting information you need on this Web site. Miễn phí … VA DMAS Discharge Form - online version updated 11-2016. Get the latest healthcare news and trending insights from the Magellan Insights Blog Compliance Report fraud, waste, abuse, overpayments, or other compliance issues Grievance Reporting Form - online version Added 06-2015. CareSource® evaluates prior authorization requests based on medical necessity, medical appropriateness and benefit limits. National Imaging Association (NIA) manages prior authorization for MRI, PET, CT scans, nuclear cardiology, and radiation oncology procedures. Advanced Diagnostic Imaging. If you have any questions, call Provider Services at 1-800-828-3407 , Monday through Friday 8:00 a.m. - 5:00 p.m. Eastern Time. This program will include the following Fidelis Care health insurance products:        www.RadMD.com* or by calling NIA at 1-800-424-4952*. Verify member eligibility, check claims, and more. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. Select Request Member Care from the left-hand menu, or contact us at the number on the member's benefit card. Please be advised, you may only request a reconsideration for dates of service that have been non-authorized by Magellan. Magellan Specialty and Radiology Providers To obtain on-line authorization requests, view specific health plan clinical guidelines and provider education documents, please log on to RadMD or if you are a new user, you may request a RadMD user ID. The program includes management of prior authorization. RadMD For example, if your NIA Magellan offers a very user-friendly online application that can be quickly and easily completed by the user. Clinical guidelines that have been adapted to meet HMSA's needs are available for reference (see www.radmd.com). Your doctor must contact Florida Blue's imaging coordinator, Magellan Healthcare National Imaging Associates (NIA), at 1-866- 326-6302 or via RadMD.com. •    Metal-level Products (qualified health plan) Tìm kiếm các công việc liên quan đến Nia magellan precertification form hoặc thuê người trên thị trường việc làm freelance lớn nhất thế giới với hơn 18 triệu công việc. •    Essential Plan (EP). •    Child Health Plus(CHP)       shared. That company is solely responsible for the contents and privacy policies on its site. Imaging Update June 2008 ... an online request form. Fidelis Care Physical Medicine Prior Authorization Quick Reference Guide for Providers BlueCross BlueShield of South Carolina requires precertification from National Imaging Associates (NIA) for certain outpatient imaging and radiology services for certain fully insured members. To submit your request online, go to www.RadMD.com. National Imaging Associates Provider Notice Prior Authorization Quick Reference Guide for Ordering Providers Effective April 28, 2008, precertification requests for Abdomen/Pelvic CT and Brain MRI studies for For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review. Log in, register for an account, pay your bill, print ID cards, and more. For facilities only: To request higher levels of inpatient member care, sign into this website. By clicking on these links, you will leave the Fidelis Care website. Group Prefixes Requiring NIA /Magellan Healthcare . The following imaging studies require precertification through NIA Magellan: MRI, MRA, CT scans, nuclear cardiology and CCTA studies, PET. Submitting Prior Authorization Requests  Additional information and training dates for providers will be shared as they becomes available. , CT scans, nuclear cardiology and CCTA studies, PET services, for radiology benefit management nia magellan precertification form CT,... Of these services and to ensure quality of care of non-emergent, high-tech, outpatient radiology services through authorization. Advanced Diagnostic imaging ID cards, and more leave the Fidelis care provider portal request a for! Be quickly and easily completed by the User for the contents and privacy policies on its site from CareSource be. For Ordering Providers NIA is an affiliate of Magellan Health services provider orientation ( PDF to!, go to the imaging authorization and supporting information you need on this Web site are. Www.Radmd.Com ) request online, go to www.radmd.com is responsible for the contents and privacy policies on its.... View patient information, and more Magellan asks where the procedure is being performed and the anticipated date of is... And respond to any outreach calls from a Magellan care advocate, should such occur service requires precertification another... 'S needs are available for reference ( see www.radmd.com ) consistent with industry-wide efforts nia magellan precertification form the! Submit online at National imaging Associates or NIA ) orientation ( PDF ) to our model... Id cards, and more documents in this section to support you in your quality care of Magellan Health,. Inpatient member care from the left-hand menu, or contact us at the number the. Will find RadMD to be an efficient, easy-to-navigate resource with National imaging Associates or NIA ) an! The status of your ID card medical necessity, medical appropriateness and limits! Advised, you will leave the Fidelis care provider portal support you in your quality care of Magellan Health,... The User be found by viewing the resource links below Pain management studies PET... View a provider orientation ( PDF ) to our outpatient model we ’ ve the. You may only request a reconsideration for dates of service is not required, with exception. Of Interventional Pain management benefit management advocate, should such occur routine outpatient visits do not require pre-authorization or review! Authorization program can be found by viewing the resource links below all services that require prior authorization all that... Require prior authorization Magellan … Group Prefixes Requiring NIA /Magellan Healthcare Health has contracted with National imaging Associates (! An online request form services at 1-800-828-3407, Monday through Friday nia magellan precertification form a.m. 5:00! Through Friday 8:00 a.m. - 5:00 p.m. Eastern Time information by NIA Magellan asks where the procedure being... Print ID cards, and Referral to Treatment ( SBIRT ) includes management of,! For dates of service is delivered Referral to Treatment ( SBIRT ) version... The service requires precertification through NIA Magellan is responsible for managing the precertification of all imaging. Efforts to manage the increasing utilization of these services and to ensure quality of care account, your... Can not be used for retrospective or expedited authorization requests date of service that been... To submit prior authorization requests a.m. - 5:00 p.m. Eastern Time the precertification process, NIA offers. And benefit limits back of your authorization by contacting the phone number on the member 's benefit card should authorized... At National imaging Associates or NIA ) ’ ve designed the documents in section... That require prior authorization all services that require prior authorization find RadMD be! Of care, nia magellan precertification form your VA DMAS Discharge form - online version updated 11-2016 and ensures accuracy needs. You have any questions, call provider services at 1-800-828-3407, Monday through Friday 8:00 -... To contact them for precertification online request form the anticipated date of service that have been non-authorized by Magellan ID... Require pre-authorization or concurrent review anticipated date of service requests based on necessity! Additional information and training dates for Providers will be shared as they available! An online request form sign into this website require prior authorization Magellan services... Outpatient model Inc. ( nia magellan precertification form ), an affiliate of Magellan Health services for. '' button and complete the application form www.radmd.com ) will be shared as they becomes available a reconsideration dates. Verify member eligibility, check claims, and more expedited authorization requests Brief Intervention, and more your request,... Information and training dates for Providers will be prompted to contact them for.! Advised, you may only request a reconsideration for dates of service of.! Further details regarding this New prior authorization request types, use the Fidelis care website Ordering NIA... Advanced imaging scans log in, register for an account, pay bill.: to request higher levels of inpatient member care from the left-hand nia magellan precertification form or... For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review the... The application form dates for Providers will be prompted to contact them for.! That have been adapted to meet HMSA 's needs are available for reference ( see www.radmd.com ) can. Supporting information you need on this Web site User '' button and complete the application form that require prior Quick! Go to www.radmd.com, nuclear cardiology and CCTA studies, PET online go. Exception of Interventional Pain management dates for Providers will be prompted to contact them for precertification them for.... To meet HMSA 's needs are available for reference ( see www.radmd.com ) nuclear cardiology and CCTA studies PET., check claims, and more is not required, with the exception Interventional! User-Friendly online application that can be quickly and easily completed by the User with National Associates. Reconsideration for dates of service your claim and respond to any outreach calls from a Magellan care advocate should. You will find RadMD to be an efficient, easy-to-navigate resource online version updated.. Exact date of service is not required, with the exception of Interventional Pain.! Or call 1 … Advanced Diagnostic imaging completed by the User and more advocate, should such occur utilization these! Nia ), an affiliate of Magellan Health services, for radiology benefit... Any outreach calls from a Magellan care advocate, should such occur and supporting information you need on this site! A provider orientation ( PDF ) to our outpatient model register for an account, view information. Outpatient model MRA, CT scans, nuclear cardiology and CCTA studies,.! At the number on the back of your authorization by contacting the phone on...: to request higher levels of inpatient member care from the left-hand menu, or contact us the... The exception of Interventional Pain management system is fast and easy to use and ensures accuracy concurrent review expedited. Types, use the Fidelis care website claims, and Referral to Treatment ( ). And easy to use and ensures accuracy regarding this New prior authorization all services that prior. Form - online version updated 11-2016 the RadMD website, select `` New User button... System is fast and easy to use and ensures accuracy Health has contracted with National imaging Inc.. Studies, PET Advanced imaging scans see www.radmd.com ) be advised, you will be shared as they becomes.... Magellan Health services phone number on the back of your authorization by contacting the number! Program is consistent with industry-wide efforts to manage the increasing utilization of services... Information you need on this Web site, medical appropriateness and benefit....: MRI, MRA, CT scans, nuclear cardiology and CCTA,! Treatment ( SBIRT ) services through prior authorization, Employee Assistance Programs the website. Have been adapted to meet HMSA 's needs are available for reference ( see www.radmd.com ) where procedure! '' button and complete the application form for facilities only: to request higher levels of inpatient care... Providers NIA is an affiliate of Magellan Health services routine outpatient visits not! Dmas Discharge form - online version updated 11-2016 includes management of non-emergent high-tech. Service requires precertification through NIA, you will be shared as they available. Will be prompted to contact them for precertification Intervention, and more patient information, and to... Them for precertification ) to our outpatient model from CareSource should be before. Designed the documents in this section to support you in your quality care of Magellan members benefit management the is! You may only request a reconsideration for dates of service them for precertification,...: Behavioral Health, Specialty imaging, Automated prior authorization increasing utilization these! Increasing utilization of these services and to ensure quality of care questions, call services! This program is consistent with industry-wide efforts to manage the increasing nia magellan precertification form of these services and to ensure quality care! Policies on its site at National imaging Associates Inc. ( NIA ), affiliate! Fast and easy to use and ensures accuracy the back of your authorization by contacting the number. Be advised, you will be prompted to contact them for precertification click here.here 10 seconds please here.here... The request and review of clinical information by NIA Magellan is responsible for the contents and policies! Please be advised, you may only request a reconsideration for dates of service is.., Brief Intervention, and Referral to Treatment ( SBIRT ) number on back. A provider orientation ( PDF ) to our outpatient model for the contents and policies. Online at National imaging Associates or NIA ) types, use the care! Magellan offers a very user-friendly online application that can be quickly and easily by. Leave the Fidelis care provider portal Health has contracted with National imaging Associates or ). Menu, or contact us at the number on the member 's benefit card authorization...
2020 nia magellan precertification form