Harvard Pilgrim has a partnership with National Imaging Associates, Inc. (NIA) to oversee prior authorization programs for certain services, including cardiac diagnostic tests and interventional procedures; diagnostic imaging; sleep studies; hip, knee, and shoulder surgery; spine surgery and cervical spine procedures; and outpatient interventional spine pain management services. You’ll find some resources for these programs here, and these and other educational materials are also available on NIA’s www.RadMD.com website.

Musculoskeletal Surgery

• MSK Program Quick Reference Guide
• MSK FAQs for Ordering Physicians
• Utilization Review Matrix for Interventional Pain Management and Musculoskeletal Surgery

Cardiac

• Cardiac Program Frequently Asked Questions for Providers
• Cardiac Program Quick Reference Guide for Providers
• NIA 2019 Utilization Review Matrix
• Cardiac Checklist

Sleep Management

• Sleep Management Program FAQ

Hip, Knee, and Shoulder Surgeries

• Hip, Knee, and Shoulder Surgeries FAQ