Dean Health Plan
Welcome to the Dean Health Plan 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.
- Dean Health Insurance Utilization Review Matrix-2022 - Updated 7/1/2022
- Dean Health Plan Provider Education Training Program
- Dean Health Plan Peer-to-Peer Process
- Prevea 360 Peer-to-Peer Process
Physical Medicine Documents
- Dean Health Plan Physical Medicine Provider Training
- Dean Health Plan Physical Medicine QRG
- Physical Medicine Checklist
- Prevea 360 Physical Medicine Provider Training
- Prevea 360 Physical Medicine QRG
- Prevea 360 Physical Medicine Checklist
- SSM Physical Medicine Provider Training
Musculoskeletal (MSK) Documents
- Dean Health Plan Place of Service Changes Provider Training PPT Slides - New
- Dean Health Plan FAQ - New
- Dean Health Plan QRG - New
- Dean Health Plan Provider Training
- Dean Health Plan Spine Surgery Utilization Review Matrix 2022
- Surgery Checklist
- Spine Surgery Authorization and Coding Reference Guide
- Dean Health Plan Hip Knee and Shoulder Utilization Review Matrix 2022
- Prevea360 Provider Training
- Prevea360 Health Plan Place of Service Changes Provider Training - New
- Prevea360 FAQ - New
- Prevea360 QRG - New
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
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.
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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.
Recorded Trainings for 2021 Program Updates - New June 2021!
RBM and Physical Medicine Clinical Guidelines
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA
- Click here to view NIA’s Physical Medicine guidelines
- Magellan adopted the use of MCG Guidelines® for its Physical Medicine product. View instructions for accessing MCG Guidelines®.
Musculoskeletal (MSK) Clinical Guidelines
- 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.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).