Centene / Peach State Health Plan
Welcome to the Peach State Health Plan page. Here you can access helpful information related to the program.
RBM Documents
- Peach State Health Plan - Frequently Asked Questions (PDF 466K)
- Peach State Health Plan - Imaging Facilities QRG (PDF 476K)
- Peach State Health Plan - Ordering Physicans QRG (PDF 406K)
- Peach State Health Plan - Provider Training (PDF 1,845K)
- Peach State Health Plan - Utilization Review Matrix (PDF 498K)
- Pediatric Imaging Spine MRI and Spine CT Test Request Tip Sheet
- Prior Authorization Checklist (PDF 281K)
- Test Request Tip Sheet (PDF 832K)
- RadMD for Ordering and Imaging Providers (PDF 96K)
- RadMD Quick Start Guide (PDF 451K)
New — Peach State Health Plan — Ordering Provider Access to RadMD
New — Peach State Health Plan — RadMD Upload Feature
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
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Refer to the Utilization Review Matrix document to view specific codes managed by NIA