The matrix below contains the cpt 4 codes for which national imaging associates, inc See the list at the left of this page (nia)* manages on behalf of independent health
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This matrix is designed to assist in the resolution of claims adjudication and claims questions related to those services authorized by nia.
How does the ordering provider obtain prior authorization from nia
What information is required in order to receive prior authorization? * effective 1/20/2023, national imaging associates, inc Is now a subsidiary of evolent health Evolent health and its affiliates and subsidiaries collectively referred to as “evolent.”
Medical necessity determinations are based on evolent clinical guidelines Evolent clinical guidelines are available on radmd.com. 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.
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 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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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
