High-Tech Imaging Change

National Imaging Associates, Inc. (NIA), a subsidiary of Magellan Health, will manage QualChoice diagnostic and cardiac imaging.

QualChoice has entered into an agreement with National Imaging Associates, Inc. (NIA), a subsidiary of Magellan Health, to manage a suite of medical specialty solutions. The program is consistent with industry-wide efforts to manage the increasing utilization of these services and to ensure quality of care.

Effective March 1, 2021, eviCore will no longer administer high-tech imaging and nuclear medicine for QualChoice. NIA will manage diagnostic (MR/CT/PET) and cardiac imaging services through QualChoice contractual relationships.

Prior authorization from NIA will be required for these non-emergent outpatient diagnostic Imaging services:

• MR
• CT/CCTA
• PET
• Nuclear Cardiology/MPI
• Stress Echo
• Echocardiography

Physicians ordering these procedures are responsible for obtaining prior authorization. The rendering facility must ensure that prior authorization is in place. We urge you to develop a process to ensure that the appropriate authorization number(s) has been obtained. Payment to the ordering physician and rendering facility will be denied for procedures performed without necessary authorization.

CPT® codes that NIA authorizes on behalf of QualChoice will be available at RadMD.com in the QualChoice/NIA Billable CPT® Codes Claim Resolution/Utilization Review Matrix.

Training Webinars

NIA will present hour-long educational sessions on the dates listed below. Only one session is required. Watch for additional communications on the webinars.

• February 2, 2021 8am CST
  Register at the following address:
  http://bit.ly/NIAtraining228am (this link is no longer active)
  
  
• February 2, 2021 12pm CST
  Register at the following address:
  http://bit.ly/NIAtraining2212pm (this link is no longer active)
  
  
• February 4, 2021 8am CST
  Register at the following address:
  http://bit.ly/NIAtraining248am (this link is no longer active)
  
  
• February 4, 2021 12pm CST
  Register at the following address:
  http://bit.ly/NIAtraining2412pm (this link is no longer active)
  
  
• February 8, 2021 12pm CST
  Register at the following address:
  http://bit.ly/NIAtraining2812pm (this link is no longer active)
  
  
• February 10, 2021 8am CST
  Register at the following address:
  http://bit.ly/NIAtraining2108am (this link is no longer active)

For questions, call NIA at 1.866.249.1587 or QualChoice Customer Service at 1.800.235.7111.