Welcome to the WellFirst Health 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, Gina Braswell.
Advanced Imaging Program
- Place of Service Changes Provider Training PPT Slides - New
- FAQ - New
- QRG - New
- Provider Training PPT
- Utilization Review Matrix 2022
- Spine Surgery Utilization Review Matrix 2022
- Spine Surgery Authorization and Coding Reference Guide
- Hip Knee and Shoulder Utilization Review Matrix 2022
- Surgery Checklist
- Peer-to-Peer Process
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
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.
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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.
Recorded Training for 2021 Program Updates - New June 2021!
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.