ConnectiCare
Welcome to the ConnectiCare page. Here you can download clinical guidelines, policies and procedures specific to both ordering providers and radiation oncology 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, Charmaine Everett.
Update on COVID-19
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Coronavirus Update for ConnectiCare Providers
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Coronavirus Update for ConnectiCare Providers serving Massachusetts Members
Spine Surgery and Interventional Pain Management Program
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Expanded Program Frequently Asked Questions
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Spine Surgery Checklist
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Spine Surgery Provider Resource Quick Reference Guide
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CPT Code Table FAQ for CCI MSK Management Program
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ConnectiCare Spine Management Education Presentation
Spine Surgery and Interventional Pain Management Clinical Guidelines
Cardiac Program
Radiation Oncology Benefits Management
NIA Radiation Oncology Clinical Guidelines
Medicare Clinical Guidelines for Radiation Oncology
Treatment Plan Checklists - Deliveries Only
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Anal Cancer Checklist Tx Del Only
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Bone Metastatic Cancer Checklist Tx Del Only
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Bone Primary Cancer Checklist Tx Del Only
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Breast Cancer Checklist Tx Del Only
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Central Nervous System (CNS) Metastatic Cancer Checklist Tx Del Only
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Central Nervous System (CNS) Primary Cancer Checklist Tx Del Only
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Cervical Cancer Checklist Tx Del Only
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Colon Cancer Checklist Tx Del Only
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Endometrial Cancer Checklist Tx Del Only
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Gastric Cancer Checklist Tx Del Only
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Head and Neck Cancer Checklist Tx Del Only
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Hodgkins Lymphoma Checklist Tx Del Only
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Non-Hodgkins Lymphoma Checklist Tx Del Only
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Non-Small Cell Lung Cancer Checklist Tx Del Only
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Pancreas Cancer Checklist Tx Del Only
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Prophylactic Cranial Irradiation Checklist Tx Del Only
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Prostate Cancer Checklist Tx Del Only
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Rectal Cancer Checklist Tx Del Only
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Skin Cancer Checklist Tx Del Only
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Small Cell Lung Cancer Checklist Tx Del Only
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Other Condition Checklist Tx Del Only
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Other Metastatic Cancer Checklist Tx Del Only
Program and Provider Education
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ConnectiCare Quick Reference Guide
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ConnectiCare Provider Education Presentation
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Radiation Therapy Treatment Notification Form for Transition Cases for Commercial/Exchange Members
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Radiation Therapy Treatment Notification Form for Transition Cases For Medicare VIP Membership
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ConnectiCare Peer-to-Peer Process
Utilization Review Matrices
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2016 AMA CPT Radiation Oncology CPT Code Changes
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ConnectiCare Utilization Review Matrix-Radiation Oncology-2022
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ConnectiCare Utilization Review Matrix-Outpatient Imaging and Cardiac Program-2022
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ConnectiCare Utilization Review Matrix-Interventional Pain Management-2022
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ConnectiCare Utilization Review Matrix-Spine Surgery-2022
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD Documents
RadMD is a user-friendly, real-time tool offered by Magellan Healthcare 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:
Tip Sheets and Checklist
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.
Clinical Guidelines
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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).