National Imaging Associates (NIA)
NH Healthy Families has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.
The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services.
NH Healthy Families oversees the NIA program and is responsible for claims adjudication. NIA manages non-emergent outpatient imaging/radiology services through contractual relationships with free-standing facilities.
Prior authorization is required for the following outpatient radiology procedures:
- PET Scan
Providers rendering the above services should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim.
Go to the NIA website for more information.
As of 3/1/2018 NIA will also be providing post service reviews on all of our outpatient physical therapy, occupational therapy and speech therapy requests. No authorization is needed for the first 80 units of therapy. For out of network requests and those requests where the member has already exhausted 80 units, Prior Authorization will need to be obtained from the Plan via fax: 866 270 8027
Please click for more information.