Ambetter from Superior Healthplan
Welcome to the Ambetter from Superior HealthPlan page. Here you can download policies and procedures specific to both ordering and rendering providers. These include quick reference guides and information designed to assist you in using RadMD to request and check the status of prior authorizations.
If you have any questions about our programs, please contact your dedicated NIA Provider Relations Manager, Gina Braswell.
Advanced Imaging Program
- Frequently Asked Questions
- Quick Reference Guide For Rendering Providers
- Quick Reference Guide For Ordering Providers
- Utilization Review Matrix-2022 +0722T & +0724T will be effective 10/01/2022
- Provider Education Presentation
Physical Medicine Program
- Physical Medicine Provider Education Presentation
- Physical Medicine Frequently Asked Questions
- Physical Medicine Quick Reference Guide
- Physical Medicine Recording of Provider Training
Genetic Testing Program
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD is a user-friendly, real-time tool offered by Magellan Healthcare that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource.
Search for resources by program:
Interventional Pain Management (IPM)
- Superior HealthPlan Interventional Pain Management (IPM) FAQ
- Superior HealthPlan Interventional Pain Management (IPM) QRG
- Superior HealthPlan Interventional Pain Management (IPM) Provider Education Presentation
- Superior HealthPlan Non CHIP Interventional Pain Management Utilization Review Matrix-2022
- Superior IPM Recording of Provider Physical Medicine Training
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.
2013 Jimmo vs Sebelius Settlement Agreement
Click here for information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA
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.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).