BlueCross BlueShield of South Carolina requires precertification from National Imaging Associates (NIA) for certain outpatient imaging and radiology services for certain fully insured members. 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. You can also check the status of your authorization by contacting the phone number on the back of your ID card. 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. You simply file your claim and respond to any outreach calls from a Magellan care advocate, should such occur. NIA Magellan is responsible for managing the precertification of all advanced imaging scans. 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. NIA, a Magellan Health Services company, is an industry-leading organization that delivers innovative solutions for effective health care 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. For example, if your The program includes management of prior authorization. Group Prefixes Requiring NIA /Magellan Healthcare . Imaging Update June 2008 ... an online request form. •    Metal-level Products (qualified health plan) The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. This program will include the following Fidelis Care health insurance products:  •    Child Health Plus(CHP) VA DMAS Discharge Form - online version updated 11-2016. Whether submitting imaging exam requests or checking the status of ordered exams, you will find RadMD to be an efficient, easy-to-navigate resource. Screening, Brief Intervention, and Referral to Treatment (SBIRT). The system is fast and easy to use and ensures accuracy.       shared. The CVR process will include the request and review of clinical information by NIA. Inpatient Discharge Checklist Added 04-27-15. For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review. Benefits of RadMD Access Whether submitting imaging exam requests or checking the status of ordered exams, you will find RadMD to be an efficient, easy-to-navigate resource. Your doctor must contact Florida Blue's imaging coordinator, Magellan Healthcare National Imaging Associates (NIA), at 1-866- 326-6302 or via RadMD.com. Simply go to the RadMD website, select "New User" button and complete the application form. • 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. Grievance Reporting Form - online version Added 06-2015. Prior Authorization and Notification Process . NIA Magellan offers a very user-friendly online application that can be quickly and easily completed by the user. If services require precertification through NIA, you will be prompted to contact them for precertification. Physicians should obtain precertification before scheduling the patient. Buckeye Health Plan has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.. 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. NIA is an affiliate of Magellan Health Services . The exact date of service is not required, with the exception of Interventional Pain Management. Log in, register for an account, pay your bill, print ID cards, and more. Submit claims electronically with Fidelis Care. If this takes longer than 10 seconds please click here.here. Select Request Member Care from the left-hand menu, or contact us at the number on the member's benefit card. MHS has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management. Effective April 28, 2008, precertification requests for Abdomen/Pelvic CT and Brain MRI studies for During the precertification process, NIA Magellan asks where the procedure is being performed and the anticipated date of service. For facilities only: To request higher levels of inpatient member care, sign into this website. CVR Summary Guide; Additional Resources. All providers will be required to obtain prior authorization for physical medicine services, which includes physical therapy, occupational therapy, and speech therapy. Magellan Healthcare Solutions for Complex Care Needs: Behavioral Health, Specialty Imaging, Automated Prior Authorization, Employee Assistance Programs. Radiology Precertification . The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. View a provider orientation (PDF) to our outpatient model. This program is consistent with industry-wide efforts to manage the increasing utilization of these services and to ensure quality of care. National Imaging Association (NIA) manages prior authorization for MRI, PET, CT scans, nuclear cardiology, and radiation oncology procedures.       New Account by selecting “Physical Medicine Practitioner.”  Your RadMD login information should not be 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. 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’ve designed the documents in this section to support you in your quality care of Magellan members. The service requires precertification through another entity (like National Imaging Associates or NIA). •    Fidelis Care at Home (FCAH - managed long term care) Utilization management systems available to submit authorization requests. EAP ; Administrative ; Clinical Additional information and training dates for providers will be shared as they becomes available. •    There are two preferred ways to submit prior authorization -- either through the NIA website at      To submit prior authorization request types, use the Fidelis Care provider portal. •    HealthierLife (HARP) You have instant access to the imaging authorization and supporting information you need on this Web site. Miễn phí … To submit your request online, go to www.RadMD.com. Services That Require Prior Authorization All services that require prior authorization from CareSource should be authorized before the service is delivered. Submitting Prior Authorization Requests  This link leads to a third party site. The following imaging studies require precertification through NIA Magellan: MRI, MRA, CT scans, nuclear cardiology and CCTA studies, PET. Log into your account, view patient information, and more. Get the latest healthcare news and trending insights from the Magellan Insights Blog Compliance Report fraud, waste, abuse, overpayments, or other compliance issues NIA is an independent company that authorizes certain … National Imaging Associates, Inc. (NIA) Authorization Program Beginning October 1, 2019, 8/5/2019 WHICH MEDICAL PROVIDERS ARE AFFECTED? Frequently Asked Questions – Fidelis Care Physical Medicine Services Prior Authorization, Clinical guidelines can be found by visiting the NIA website at www.RadMD.com. That company is solely responsible for the contents and privacy policies on its site. Prior Authorization Quick Reference Guide for Ordering Providers National Imaging Associates Provider Notice *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. As pioneers in specialty drug management, industry leaders in Medicaid pharmacy programs and disruptors in pharmacy benefit management, we partner with our customers and members to deliver a best-in-class healthcare experience. Verify member eligibility, check claims, and more. Clinical guidelines that have been adapted to meet HMSA's needs are available for reference (see www.radmd.com). ... Services Managed by NIA Magellan … 3. 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. Please be advised, you may only request a reconsideration for dates of service that have been non-authorized by Magellan. Submit online at National Imaging Associates or call 1 …       www.RadMD.com* or by calling NIA at 1-800-424-4952*. For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review. ©1999-2020 Magellan Health, Inc. ALL_RIGHTS_RESERVED. General Precertification. 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. You simply file your claim and respond to any outreach calls from a Magellan care advocate, should such occur. Shaping the future of pharmacy. Iowa Total Care uses prior authorizations to ensure that all care delivered to our members is medically necessary and appropriate based on the member’s type and severity of condition. View a provider orientation (PDF) to our outpatient model. 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 NIA website cannot be used for retrospective or expedited authorization requests. By clicking on these links, you will leave the Fidelis Care website. RadMD •    To get started, go to www.RadMD.com click the New User button and submit a RadMD Application for  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. Resources It is a “smart” application which only will ask you questions that apply directly to your practice, based on the previous responses you provided. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. RadMD is a user-friendly, real-time automated tool that gives instant access to advanced imaging, cardiac, physical medicine and other specialty procedure authorizations. Fax the completed form to Pharmacy Services 1-860-674-2851 or mail to ConnectiCare, Attn: Pharmacy Services, 175 Scott Swamp Road, PO Box 4050, Farmington, CT 06034-4050. Magnolia Health has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.. Reconsideration Form. NIA is an independent CareSource® evaluates prior authorization requests based on medical necessity, medical appropriateness and benefit limits. Advanced Diagnostic Imaging. Grievance Reporting Form. (NIA) that provides you with instant access to the high-tech imaging authorization and supporting information you need, in an easily accessible Internet format. (PAGE_LAST_UPDATED 09/2020) Fidelis Care Physical Medicine Prior Authorization Quick Reference Guide for Providers Prior Authorization. Iowa Total Care has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.. Authorizations. We work with National Imaging Associates (NIA) Magellan Healthcare to manage radiology prior authorizations on behalf of BlueCross BlueShield of South Carolina. Access the user guide here. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. •    Medicaid Managed Care (NYM)     •    Essential Plan (EP). The Medical Form Resource Center (MFRC) is an online tool created to allow you to submit your precertification requests for some services electronically. Further details regarding this new prior authorization program can be found by viewing the resource links below. 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