Health Plans

Ambetter of Tennessee

Welcome to the Ambetter from Ambetter of Tennessee Health Plan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and information designed to assist you in using the RadMD Website to obtain and check authorizations.

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

Update on COVID-19

Role of CT in Detection of COVID-19

Documents

Physical Medicine Effective January 1, 2021

RadMD Documents

RadMD is our user-friendly, real-time tool that provides you with instant access to the high-tech imaging authorization and supporting information you need. Whether submitting imaging exam requests or checking the status of a prior authorization request, you will find RadMD to be an efficient, easy-to-navigate resource.

Search for resources by solution below:

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.

Click the link below to see information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.

2013 Jimmo vs Sebelius

Clinical Guidelines

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.