National Imaging Associates, a Magellan Health Services Company
Welcome to RADMD

Health Plans

Tufts Health Plan

Welcome to the Tufts Health Plan 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, April Sabino.

Effective November 1, 2016

Massachusetts Imaging Prior Authorization Form

State Authorization Requirements and Clinical Criteria 

Documents

Codes highlighted in yellow do not require pre-authorization or medical necessity review for members under 18 years. 

Spine Management and Joint Surgery

Cardiac Management Effective 1/1/2017       

Tufts Health Plan expanded their cardiac study prior authorization program to include Cardiac Catheterizations, Echocardiography, Stress Echocardiography, and Implantable Cardiac Devices effective January 1, 2017.  

Conservative Treatment Forms

For access to our conservative treatment forms, click here.

RadMD Documents 

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.

Search for resources by program:

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.

Update on COVID-19

Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).