National Imaging Associates (NIA)

Sunshine Health has contracted with National Imaging Associates Inc. (NIA), an affiliate of Magellan Health Services, for radiology and cardiac imaging benefit management.

The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services.

Sunshine Health manages the provider network and claims adjudication.

Prior authorization is required for the following outpatient radiology procedures:

• CT/CTA/CCTA
• MRI/MRA
• PET Scan
• Myocardial Perfusion Imaging
• MUGA Scan
• Stress Echocardiography
• Echocardiography

KEY PROVISION:

Providers rendering the above services should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim.

Go to the NIA website for more information.