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*MEDICAID/ NIA PRIOR AUTHORIZATION REQUIREMENTS - EFFECTIVE 7/1/2023*

Date: 05/02/23

National Imaging Associates, Inc. (NIA) provides utilization management for non-emergent Medical Specialty Solutions for Magnolia Health members. Magnolia Health has expanded its partnership with NIA to streamline authorization processes and improve member outcomes. As a result, effective July 1, 2023, NIA will expand the prior authorization program to include the following types of non-emergent outpatient Medical Specialty Solution services:

  • Left Heart Catheterization
  • Interventional Pain Management (IPM)
  • Physical Medicine Services (Physical, Occupational and Speech Therapy)

Providers may begin contacting NIA on July 1, 2023, to seek prior authorization for the above-mentioned services scheduled on or after July 1, 2023. NIA will manage the services through Magnolia Health contractual relationships with providers.

Please note:

The ordering physician is responsible for obtaining authorization before rendering the above-listed services. To obtain authorization, providers should proceed to the NIA website www.RadMD.com, or use the following toll-free phone number:  1-866-912-6285.

Providers rendering the above services should verify that the authorization has been obtained by visiting www.RadMD.com or calling NIA. Please do so to avoid nonpayment of your claim.

Emergency room and inpatient Medical Specialty Solution procedures do not require authorization.

We appreciate your continued support. You can soon expect to receive more specific information regarding authorization processes for these Medical Specialty Solutions services. If you have questions about this notice, don't hesitate to contact Magnolia Health provider services at 1-866-912-6285.