Reference Materials

• 2023 Provider and Billing Manual (PDF)
  
• 2022 Provider and Billing Manual (PDF)
• Inpatient Authorization Form (PDF)
• Outpatient Authorization Form (PDF)
• Well-Being Survey (PDF)
• Member Notification of Pregnancy (PDF)
• Notification of Pregnancy Form (PDF)
  
• Known Issues and Resolution Timeframes
• No Surprises Act Open Negotiation Form (PDF)
  
• Claim Dispute Form (PDF)
  

National Imaging Associates (NIA) Documents

• National Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQ’s) Prior Authorization Program Physical Medicine Services (PDF)
• Physical Medicine Program Provider Training (PDF)
• Physical Medicine Prior Authorization Quick Reference Guide for Providers (PDF)
• Physical Medicine Request Tip Sheet/Checklist (PDF)
• RadMD Access for Physical Medicine Providers to Request Prior Authorization (PDF)
• RadMD Quick Start Guide Physical Medicine Authorization Requests (PDF)

ABA Tip Sheets

• Caregiver Training (PDF)
• Coordination of Care (PDF)
• Functional Behavior Assessments and Behavior Intervention Plans (PDF)
• Medication Management (PDF)
• Prescription Fulfillment (PDF)
• Transition Planning (PDF)