Centene / Home State Health Plan
Welcome to the Centene / Home State Health Plan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view 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
Effective November 1, 2019, a change will go into effect to promote the use of the appropriate setting for advanced imaging services (CT and MR).
Facility Site Selection Program
- Home State Health Plan Facility Site Selection Provider Notice
- Home State Health Plan Facility Site Selection Questions and Answers
- Home State Health Facility Site Selection Provider Training PPT
- Appropriate Site of Service for Advanced Radiology Imaging Policy
- Home State Health Plan Cardiac Checklist
- Home State Health Plan Provider Cardiac Imaging Frequently Asked Questions
- Home State Health Plan Provider Frequently Asked Questions
- Home State Health Plan Quick Reference Guide for Providers
- Home State Health Plan Provider Training Presentation
- Home State Health Plan Training Evaluation Form
- Home State Health Plan Utilization Review Matrix-2021
- Pediatric Tip Sheet
- Test Request Tip Sheet
- Home State Health Plan Peer-to-Peer Process
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.
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Effective June 1, 2019, physical medicine services (physical therapy, occupational therapy and speech therapy) will no longer be managed through a post-service review process. Therefore, beginning June 1, 2019, Home State Health Plan will implement a prior authorization of outpatient physical medicine services for its Medicaid membership.
- Physical Medicine Frequently Asked Questions
- Physical Medicine Quick Reference Guide
- Physical Medicine Tip Sheet/Checklist
- Physical Medicine Provider Training PPT
- Outpatient Habilitative Speech Therapy Guideline
- Outpatient Habilitative PT and OT Therapy Guideline
- Date Extension Announcement for Physical Medicine Providers (New)
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.
- 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.