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

Health Plans

WellCare of Kentucky

 

Welcome to the WellCare of Kentucky Medicare and Medicaid 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, Andrew Dietz.

Alert

  • WellCare of KY Medicaid no longer requires an authorization for requests with POS 22 for DOS 8/11/2021 and beyond.
  • Kentucky Department for Medicaid Services recently announced that services performed in an On Campus-Outpatient Hospital setting, POS 22, do not require a prior authorization. 

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.”

Update on Physical Medicine 

Due to unforeseen operational challenges, these programs have been delayed until further notice. eviCore will continue to manage all rehabilitative and habilitative physical medicine requests for the time being. Therefore, please continue to submit prior authorization to eviCore until further notice.  Please be on the lookout for further communication on this topic in the future.

Advanced Imaging Program

Interventional Pain Management (IPM) Program

Conservative Treatment Forms

For access to our conservative treatment forms, click here.

Low Dose Chest CT History Form

RadMD Documents

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.

2013 Jimmo vs Sebelius Settlement Agreement

Click here for information about the 2013 Jimmo v. Sebelius settlement involving skilled nursing and skilled therapy services.

Clinical Guidelines

  • Clinical Guidelines
  • Refer to the Utilization Review Matrix document to view specific codes managed by NIA  
  • Click here to view NIA’s Physical Medicine guidelines

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).