Health Plans

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

Notice About Authorization Letters for Advanced Radiology Services and Lumbar

Update on COVID-19

Documents

Spine Care Program

Cardiac Educational Documents

Prior Authorization Form

Presbyterian Health Plan - Prior Authorization Form

RadMD Documents

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

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.