National Imaging Associates (NIA)

Effective August 2, 2010, Buckeye Community Health Plan is contracted with National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health Services, for radiology 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.

Buckeye oversees the NIA program and is responsible for claims adjudication.  NIA manages non-emergent outpatient imaging/radiology services through contractual relationships with free-standing facilities. 

Prior authorization is required for the following outpatient radiology procedures:

  • CT /CTA/CCTA 
  • MRI/MRA                                                                                              
  • PET Scan

KEY PROVISIONS:

  • Emergency room, observation and inpatient imaging procedures do not require authorization.  
  • It is the responsibility of the ordering physician to obtain authorization.
  • 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.