AmeriHealth Caritas Pennsylvania
Welcome to the AmeriHealth Caritas Pennsylvania 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, Lori Fink.
Update on COVID-19
Documents
- AmeriHealth Caritas Pennsylvania Provider FAQ
- AmeriHealth Caritas Pennsylvania Utilization Review Matrix-2021
- AmeriHealth Caritas Pennsylvania Prior Authorization Checklist
- AmeriHealth Caritas Pennsylvania Provider Training Program
- AmeriHealth Caritas Pennsylvania Quick Reference Guide for Imaging Facilities
- AmeriHealth Caritas Pennsylvania Quick Reference Guide for Ordering Physicians
- Tipsheet for Ordering Advanced Imaging Studies
- Conservative Treatment Form
Cardiac Education
- AmeriHealth Caritas Pennsylvania/ NIA Cardiac Frequently Asked Questions
- AmeriHealth Caritas Pennsylvania/ Cardiac Checklist
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.
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.