AmeriHealth Caritas Northeast
Welcome to the AmeriHealth Caritas Northeast 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.
AmeriHealth Caritas Northeast has changed its name in the northeast region of Pennsylvania to AmeriHealth Caritas Pennsylvania effective Jan. 1, 2021. The managed care organization said the change is designed to align its naming across the commonwealth outside of the southeast region. Please see AmeriHealth Caritas Pennsylvania for all educational materials.
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 Northeast Provider FAQ
- NIA Medical Specialty Solutions Provider Training
- AmeriHealth Northeast Prior Authorization Checklist
- AmeriHealth Northeast Quick Reference Guide for Imaging Facilities
- AmeriHealth Northeast Quick Reference Guide for Ordering Physicians
- Tipsheet for Ordering Advanced Imaging Studies
Cardiac Education
- AmeriHealth Northeast/ NIA Cardiac Frequently Asked Questions
- AmeriHealth Northeast/ 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.