WellCare of New Jersey
Welcome to the WellCare of New Jersey page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and 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: Seth Cohen
Update on COVID-19
Physical Medicine Documents
- WellCare of NJ Physical Medicine FAQs
- WellCare of NJ Physical Medicine Tip Sheet/Checklist
- WellCare of NJ Physical Medicine Quick Reference Guide
- WellCare of NJ Physical Medicine Provider Training
- Wellcare of NJ Physical Medicine Provider Training Video
Interventional Pain Management (IPM) Documents
- WellCare of NJ IPM FAQs
- WellCare of NJ IPM Checklist
- WellCare of NJ IPM Quick Reference Guide
- WellCare of NJ IPM Provider Training
- WellCare of NJ IPM Utilization Review Matrix 2021
- WellCare of NJ IPM Conservative Treatment Form
- WellCare of NJ IPM Provider Training Video
Advanced Imaging and Cardiac Study Documents
- WellCare of NJ RBM Frequently Asked Questions
- WellCare of NJ RBM Ordering Provider Quick Reference Guide
- WellCare of NJ RBM Rendering Provider Quick Reference Guide
- WellCare of NJ Provider Education PowerPoint
- WellCare of NJ Prior Authorization Checklist
- WellCare of NJ Cardiac Solutions Frequently Asked Questions
- WellCare of NJ Cardiac Solutions Tip Sheet
- WellCare of NJ Utilization Review Matrix (Medicaid)-2021
- WellCare of NJ Utilization Review Matrix (Medicare)-2021
- WellCare of NJ Medical Specialty Solutions Provider Training
- WellCare of NJ Imaging Conservative Treatment 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.
Click the link below to see 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.