Centene / Peach State Health Plan
Welcome to the Peach State Health Plan page. Here you can access helpful information related to the program.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Tony Salvati.
Update on COVID-19
RBM Documents
- Peach State Health Plan - Frequently Asked Questions
- Peach State Health Plan - Imaging Facilities QRG
- Peach State Health Plan - Ordering Physicans QRG
- Peach State Health Plan - Provider Training
- Peach State Health Plan - Utilization Review Matrix-2020
- Pediatric Tip Sheet
- Prior Authorization Checklist
- Test Request Tip Sheet
RadMD Documents
- RadMD Flyer
- RadMD for Ordering and Imaging Providers
- RadMD Quick Start Guide
- Ordering Provider Access to RadMD
- RadMD Upload Feature
Recorded General Trainings
Recorded RadMD Demos
NIA Facility Selection Program Updates
- NIA Facility Selection Program Announcement Letter
- NIA Facility Selection Program Announcement Letter for CHOA
Effective November 15, 2017, and for all dates of service thereafter, if you do not select a convenient, cost-effective, in-network imaging facility at intake, NIA will assign one without outreach to the member. In addition, the imaging provider selected will become the provider of record for claims payment of that claim. Any claim billed with an imaging provider that differs from the imaging provider selected/assigned during the authorization process will be denied.
Click here to see information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.
Clinical Guidelines
- Clinical Guidelines
-
Refer to the Utilization Review Matrix document to view specific codes managed by NIA