Tufts Health Public Plans
Welcome to the Tufts Health Public Plans 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, Seth Cohen.
Effective 1/20/2023, National Imaging Associates, Inc. is now a subsidiary of Evolent Health. Evolent Health and its affiliates and subsidiaries collectively referred to as “Evolent.”
Effective November 1, 2016
Massachusetts Imaging Prior Authorization Form
- Frequently asked questions (for NWH website and RadMD)
- Tufts Health Public Plans Prior Authorization Information
- Tufts Health Public Plans Provider Training
- Tufts Health Public Plans Utilization Review Matrix-2023
For access to our Advanced Imaging Program tip sheets/checklists, click here.
Spine Management and Joint Surgery
- Tufts Health Public Plans Spine Surgery Utilization Review Matrix-2023
- Tufts Health Public Plans Hip, Knee and Shoulder Surgery Utilization Review Matrix-2023
- Tufts Health Public Plans IPM Utilization Review Matrix-2023
- Tufts Health Public Plans Spine Management - Provider Training
- Tufts Health Public Plans Frequently Asked Questions Interventional Pain Management
- Tufts Health Public Plans Frequently Asked Questions Surgery Lumbar and Cervical
- Tufts Health Public Plans Spine Pain Management QRG
- Tufts Health Public Plans Joint Surgery Provider Training PPT
- Tufts Health Public Plans FAQ - Joint Surgery
- Tufts Health Public Plans Ordering QRG Joint Surgery
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD is a user-friendly, real-time tool offered by NIA 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 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.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).