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.
Contact NIA online or by telephone.
Authorization status and approved transaction numbers are also available to servicing providers through HPHConnect and NEHEN. Status and transaction numbers can be accessed through NIA’s website at www.radmd.com.
- NIA 2021 Utilization Review Matrix for Medicare Advantage
- NIA 2021 Utilization Review Matrix for Commercial Members
- Utilization Review Matrix for Interventional Pain Management
- Utilization Review Matrix for Musculoskeletal Surgery (Spine)
- Utilization Review Matrix for Musculoskeletal Surgery (Hip, Knee and Shoulder)