All Health Plans

Aetna

Welcome to the Aetna page. Here you can access useful materials about the program.

Aetna has selected National Imaging Associates, Inc. (NIA) to provide utilization management for physical medicine. Beginning September 1, 2018, for Delaware, New York, Pennsylvania and West Virginia, providers must request prior authorization for physical therapy, occupational therapy and chiropractic services through NIA at RadMD.com.

Refer to the state-specific CPT Matrix document below to view specific codes managed by NIA.

If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager:

Delaware: Charmaine Everett
New Jersey: Seth Cohen
New York: Seth Cohen
Pennsylvania: Seth Cohen
West Virginia: Seth Cohen

News and Updates

Delaware

New Jersey

New York

Western New York

Pennsylvania

West Virginia

Documents

RadMD User References

Recorded General Trainings

We have a series of training videos that discuss the components of requesting a prior authorization request. Click here to access these videos.

Recorded RadMD Demos

Need additional help using RadMD? Click here to access a series of RadMD demos that demonstrate how to properly submit a prior authorization request.

Physical Medicine Guidelines

Refer to the state-specific CPT Matrix document above to view specific codes managed by NIA.

Physical Medicine Guidelines

MCG Guidelines®

Magellan adopted the use of MCG Guidelines® for its Physical Medicine product. More information available here: /media/871888/instructions-for-accessing-mcg-guidelines-ambcare.pdf

Clinical Training Modules

We have a series of clinical training modules that will help you avoid delays and ensure that you have the right information before submitting your prior authorization request. Click here to access them.