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 Web site to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Justin Clifford.
Update on COVID-19
Documents
- 2020 Medical Specialty Solutions Utilization Review Matrix
- Medical Specialty Solutions FAQ
- Medical Specialty Solutions Announcement Letter
- Medical Specialty Solutions QRG
- Medical Specialty Solutions Program is Replacing Health Help
- Ordering Provider Access to RadMD
- RadMD Quick Start Guide
- RadMD for Ordering and Rendering Providers
- RadMD Upload Feature
- Tip Sheet for Imaging
- Tip Sheet for Imaging for Pediatrics
- Provider Training PPT Updated 5/7/20
- Prior Authorization Checklist
Spine Care Program
- Announcement Letter - NIA Spine Management Program (PDF 145K)
- NIA Frequently Asked Questions (FAQ’s) (PDF 384K)
- 2020 Spine Management Surgery Utilization Matrix
- Spine Management Provider Presentation (PDF 1,252K)
- Spine Pain Management Quick Reference Guide for Ordering Physicians/Surgeons (PDF 444K )
- Spine Surgery Checklist (PDF 478K )
Cardiac Educational Documents
- Cardiac Solutions Tip Sheet
- Medical Specialty Solutions Cardiac Checklist
- Medical Specialty Solutions Cardiac Imaging FAQ
- Medical Specialty Solutions Cardiac Announcement Letter
- MPI versus Stress Echo Tip Sheet
Prior Authorization Form
NIA Clinical Guidelines
- Clinical Guidelines
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Refer to the Utilization Review Matrix document to view specific codes managed by NIA