Welcome to the Meridian Illinois 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, Leta Genasci.
Outpatient MeridianComplete Imaging and Cardiac Program
- MeridianComplete Utilization Review Matrix-2022
- MeridianComplete Quick Reference Guide
- MeridianComplete Frequently Asked Questions
- MeridianComplete Cardiac Frequently Asked Questions
- MeridianComplete Cardiac Checklist
- MeridianComplete Provider Training PPT
- MeridianComplete Prior Authorization Checklist
- MeridianComplete Tip Sheet
- MeridianComplete Pediatric Tip Sheet
- MeridianComplete Peer-to-Peer Process
Outpatient MeridianHealth Imaging and Cardiac Program
- MeridianHealth Utilization Review Matrix-2022
- MeridianHealth Announcement Letter
- MeridianHealth Provider Training PPT
- MeridianHealth Frequently Asked Questions
- MeridianHealth Quick Reference Guide
- MeridianHealth Utilization Review Matrix
- MeridianHealth Prior Authorization Checklist
- MeridianHealth Cardiac Checklist
- MeridianHealth Tip Sheet
- MeridianHealth Pediatric Tip Sheet
- MeridianHealth Peer-to-Peer Process
Interventional Pain Management
- MeridianHealth Interventional Pain Management QRG
- MeridianHealth Interventional Pain Management FAQ
- MeridianHealth Interventional Pain Management Provider Training
- MeridianHealth Interventional Pain Management Checklist
- MeridianHealth Interventional Pain Management Utilization Review Matrix-2022
YouthCare HealthChoice Illinois
- YouthCare HealthChoice Illinois Provider Training PPT
- YouthCare HealthChoice Illinois Utilization Review Matrix 2022
- YouthCare HealthChoice Illinois Frequently Asked Questions
- YouthCare HealthChoice Illinois Quick Reference Guide
- YouthCare HealthChoice Illinois Prior Authorization Checklist
- YouthCare HealthChoice Illinois Tip Sheet
- YouthCare HealthChoice Illinois Pediatric Tip Sheet
- YouthCare HealthChoice Peer-to-Peer Process
- MeridianComplete Physical Medicine Quick Reference Guide
- MeridianComplete Physical Medicine Frequently Asked Questions
- MeridianComplete Physical Medicine Checklist/Tip Sheet
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.
2013 Jimmo vs Sebelius Settlement Agreement
Click here for information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.
Click here to view NIA’s Physical Medicine guidelinesMagellan adopted the use of MCG Guidelines® for its Physical Medicine product. View instructions for accessing MCG Guidelines®.
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).