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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. 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.
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. How does the ordering provider obtain a prior authorization from nia for a medical specialty solutions outpatient service
What information does nia require before a medical necessity review can be initiated for prior authorization determination The policies constitute only the reimbursement and coverage guidelines of nia Coverage for services varies for individual members in accordance with the terms and conditions of applicable certific tes of coverage, summary plan descriptions, or contracts with governing regulatory
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