Tuesday, 7 August 2012

AvMed has partnered with National Imaging Associates to provide authorization for Advanced Radiology Services

Effective from May 1, 2012 National Imaging Associates, Inc provides prior authorization for outpatient CT, MRI, PET, CCTA, Nuclear Cardiology and Stress Echo imaging procedures.

Procedures require prior authorization
  • CT/CTA
  • PET
  • CCTA
  • Nuclear Cardiology
  • Stress Echo
Services do not require prior authorization
  • Inpatient advanced radiology services
  • Observation setting advanced radiology services
  • Emergency Room radiology services
How to request authorization from National Imaging Associates?

We can request authorization from NIA in two ways as below
  • Website-  (registration required, Sunday through Friday, 5:00 a.m. to 12:00 a.m. EST and Saturday 8:00 a.m. to 1:00 p.m. EST)
  • Phone-866-663-8387 (Monday to Friday @ 8.00 AM to 9.00 PM EST)
What we need to obtain prior authorization?
  • Name and office phone number of ordering physician
  • Member name and ID number
  • Requested examination
  • Name of provider office or facility where the service will be performed
  • Anticipated date of service (if known)
  • Details justifying examination
  • Symptoms and their duration
  1. Physical exam findings
  2. Conservative treatment patient has already completed (e.g., physical therapy, chiropractic or
  3. osteopathic manipulation, hot pads, massage, ice packs, medications) Preliminary procedures already
  4. completed (e.g., x-rays, CTs, lab work, ultrasound, scoped procedures, referrals to specialist, specialist evaluation)
  5. Reason the study is being requested (e.g., further evaluation, rule out a disorder)
  • Please be prepared to fax the following information, if requested:
  1. Clinical notes             
  2. X-ray reports
  3. Specialist reports/evaluation
  4. Ultrasound reports
  5. Previous CT/MRI reports


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