Centene / Sunshine Health
Welcome to the Sunshine Health Plan 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.
In keeping with our commitment to promote continuous quality improvement for services provided to Sunshine Health members, Sunshine Health is expanding its existing partnership with NIA to include prior authorization of outpatient cardiac procedures, effective April 1, 2021.
- Muga Scan
- Myocardial Perfusion Imaging (MPI)
- Stress Echocardiography
- Echocardiography (TTE/TEE)
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Andrew Dietz.
Update on COVID-19
- Provider Notification Letter
- Provider Education PowerPoint
- Quick Reference Guide for Ordering and Imaging Facilities
- Frequently Asked Questions
- Utilization Review Matrix-2021
- Prior Authorization Checklist
- Tip Sheet for Ordering Advanced Imaging Studies
- Cardiac Checklist
- Cardiac Frequenty Asked Questions - effective 04/01/2021
- Cardiac Tip Sheet
- Cardiac Tip Sheet - Myocardial Perfusion Imaging vs. Stress Echo
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.
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.