Centene / Superior Healthplan
Welcome to the Superior Healthplan page. Here you can download policies and procedures specific to both ordering and rendering providers. These include quick reference guides and information designed to assist you in using RadMD to request and check the status of prior authorizations.
If you have any questions about our programs, please contact your dedicated NIA Provider Relations Manager, Gina Braswell.
Effective 1/20/2023, National Imaging Associates, Inc. is now a subsidiary of Evolent Health. Evolent Health and its affiliates and subsidiaries collectively referred to as “Evolent.”
Advanced Imaging Program
- Quick Reference Guide for Ordering Providers
- Quick Reference Guide for Rendering Providers
- Frequently Asked Questions
- Medicaid Utilization Review Matrix-2023
- Medicaid Star Plus Utilization Review Matrix-2023
- Medicare Utilization Review Matrix-2023
- Provider Education Presentation
- Prior Authorization Request Form
For access to our Advanced Imaging Program tip sheets/checklists, click here.
Cardiac Program
- Cardiac Tip Sheet
- Cardiac Tip Sheet for MPI vs SE
- Cardiac Checklist
- Cardiac Frequently Asked Questions
- Cardiac Medicaid Utilization Review Matrix-2023
- Cardiac Medicaid Star Plus Utilization Review Matrix-2023
- Cardiac Medicare Utilization Review Matrix-2023
Physical Medicine Program
- Physical Medicine Frequently Asked Questions
- Physical Medicine Quick Reference Guide
- Physical Medicine Provider Education Presentation
- Physical Medicine Recording of Provider Training
- Outpatient Habilitative and Rehabilitative Speech Therapy
- Outpatient Habilitative Physical and Occupational Therapy
- Record Keeping and Documentation Standards
For access to our Physical Medicine Program tip sheets/checklists, click here.
Interventional Pain Management (IPM) Program
- IPM Frequently Asked Questions
- IPM Quick Reference Guide
- IPM Provider Education Presentation
- IPM Utilization Review Matrix-2023
Facility Scheduling Program
- Facility Selection and Member Scheduling Provider Announcement Letter
- Questions and Answers for Facility Scheduling Program
Genetic Testing Program - Effective date is November 1, 2022.
- Genetic Testing and Laboratory Utilization Review Matrix-2023 - Updated 9/1/2023
- Genetic Testing Clinical Guidelines
- Genetic Testing Frequently Asked Questions
- Genetic Testing Quick Start Guide
- Genetic Testing Provider Education Presentation
- Genetic Testing Checklist
- Genetic Testing Recorded Provider Training
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD Documents
RadMD is a user-friendly, real-time tool offered by NIA that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource.
Search for resources by program:
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.
2013 Jimmo vs Sebelius Settlement Agreement
Click here for 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
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.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).