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Here you can access our clinical guidelines and resources, as well as useful information related to the programs shown on the left hand side of this page What information is required to receive prior authorization? We strongly recommend using radmd to request a prior authorization
If you do need to call, please use the phone number that has been designated for your evolent prior authorizations How does the ordering provider obtain a prior authorization from nia for a medical specialty solutions outpatient service That number can be found.
Our system provides instant access to much of the prior authorization information that our call center staff provides
You have instant access to the imaging authorization and supporting information you need on this site Whether submitting imaging exam requests or checking the status. These medical necessity criteria were developed by evolent for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups
Evolent’s guidelines are reviewed yearly and modified when. Nia’s clinical guidelines are on radmd.com* under online tools/clinical guidelines Nia’s guidelines for medical specialty solutions services were developed from practice experience, literature reviews, specialty criteria sets and empirical data. Clinical guidelines 2025 advanced imaging guidelines checklists advanced imaging checklist low dose chest ct history form tip sheets advanced imaging test request tip.
Click here for a complete list of telephone numbers.
Nia’s guidelines are reviewed yearly and modified when necessary following a literature search of pertinent and established clinical guidelines and accepted diagnostic imaging practices. For assistance, please contact the provider support team at That number can be found on radmd and may vary according to the member’s health plan Who can a provider contact at nia for more information
You may contact your dedicated nia provider relations manager
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