Presbyterian Health Plan
Welcome to the Presbyterian Health Plan page. Here you can download policies and procedures specific to the ordering physicians/surgeons and 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, Gina Braswell.
News and Updates
Update on COVID-19
- Medical Specialty Solutions Utilization Review Matrix-2021
- Medical Specialty Solutions FAQ
- Medical Specialty Solutions QRG
- Medical Specialty Solutions Program is Replacing Health Help
- Tip Sheet for Imaging
- Tip Sheet for Imaging for Pediatrics
- Provider Training PPT Updated 5/7/20
- Prior Authorization Checklist
Spine Care Program
- NIA Frequently Asked Questions (FAQ’s)
- Spine Management Surgery Utilization Review Matrix-2021
- Spine Management Provider Presentation
- Spine Pain Management Quick Reference Guide for Ordering Physicians/Surgeons
- Spine Surgery Checklist
Cardiac Educational Documents
- Cardiac Solutions Tip Sheet
- Medical Specialty Solutions Cardiac Checklist
- Medical Specialty Solutions Cardiac Imaging FAQ
- MPI versus Stress Echo Tip Sheet
Prior Authorization Form
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.
- 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.