Centene / Kentucky Spirit Health Plan
Welcome to the Centene / Kentucky Spirit Health Plan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Web site to obtain and check authorizations.
Documents
- Kentucky Spirit/NIA Quick Reference Guide for Ordering Providers - Updated 10/17/11 (PDF 264K
) - Kentucky Spirit/NIA Quick Reference Guide for Imaging Facilities - Updated 10/17/11 (PDF 261K
) - Kentucky Spirit/NIA 2012 CPT Code Matrix - Updated 02/21/02 (PDF 158K
) - Kentucky Spirit/NIA Frequently Asked Questions - Updated 11/22/11 (PDF 90K
) - Kentucky Spirit/NIA Provider Education Presentation- Updated 11/15/11 (PPT 2178K
) - Kentucky Spirit/NIA RBM Educational Flyer (PDF 100K
) - Kentucky Spirit Training Evaluation Form (PDF 29K
) - RadMD Benefits and Logon (PDF 78K
) - RadMD Quick Start Guide (PDF 40K
) - Sample NIA OCR Fax Cover Sheet (PDF 55K
) - Kentucky Spirit Global Choices Benefit Plan Summary (PDF 37K
) - Kentucky Spirit Family Choices Benefit Plan Summary (PDF 35K
)
Attention Rendering Providers: Please be aware certain Kentucky Spirit Health Plan members in the Global Choices Benefit plan have a copay for Outpatient Radiology Services as outlined in the posted benefit summary.
Effective November 1, 2011, Kentucky Spirit Health Plan is contracted with National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health Services, for radiology benefit management.
You may reach NIA directly at 1-877-290-2051 or http://www1.radmd.com/ for prior authorization of the below services:
The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization.
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:
- CT /CTA/CCTA
- MRI/MRA
- PET Scan
KEY PROVISIONS:
- Emergency room, observation and inpatient imaging procedures do not require authorization.
- It is the responsibility of the ordering physician to obtain authorization.
- 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.
