Welcome to our CareSource Ohio Materials page. Here you are able to download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and the CareSource/NIA imaging provider handbook. You can also view information designed to assist you in using the RadMD Web site to obtain and check authorizations.
GOOD NEWS! NIA has implemented new functionality that makes it easier for CareSource providers to access the RadMD.com Web site. Beginning Jan. 30, 2010, providers can access RadMD directly from the CareSource provider Web site. This means that users coming from the CareSource site no longer have to sign in again when they are directed to NIA's RadMD site.
Effective 1/1/18, in addition to the management of MR, CT and PET, prior authorization will be required for the following cardiac procedures for ONLY CareSource OH Exchange, Medicare, Medicare Advantage, ABD Adults and MAGI members as well as CareSource KY, WV and IN Exchange.
- Myocardial Perfusion Imaging (MPI)
- MUGA Scans
- Echocardiography (Transthoracic and Transesophageal Echocardiography)
- Stress Echocardiography
Note: The above cardiac procedures will NOT require prior authorization for Ohio CFC and ABD Kids and Indiana and Georgia Medicaid members.
- CareSource Imaging Provider Handbook (PDF 316K)
- CareSource Privileging Application
- CareSource Provider Frequently Asked Questions (PDF 197K)
- CareSource Quick Reference Guide for Imaging Providers (PDF 108K)
- CareSource Quick Reference Guide for Ordering Physicians (PDF 101K)
- CareSource Utilization Review Matrix (PDF 264K)
- RadMD Benefits Flyer (PDF 50K)
- RadMD Quick Start Guide (PDF 44K)
- CareSource Cardiac Imaging Frequently Asked Questions (PDF 184K)
- Tip Sheet for Cardiac Solution (PDF 122K)
- Tip Sheet for MPI vs Stress Echo (PDF 130K)
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA
Prior Authorization Requirements
Effective July 1, 2009, prior authorization will be required for the following non-emergent outpatient radiology procedures for CareSource membership:
- MRI/MRA scan
- CT scan
- PET scan