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2022-02 NIA to Manage Authorizations for IPM and Certain Cardiac Procedures Effective July 1

Date: 04/25/22

To align our prior authorization process with industry best practices and streamline administrative processes for our providers and members, Ambetter from Louisiana Healthcare Connections will expand our partnership with National Imaging Associates (NIA) to include Interventional Pain Management (IPM) and additional certain cardiac-related procedures effective July 1, 2022. Our shared goal is to help your patients get the care they need with less administrative burden for your practice.

Providers may begin contacting NIA on July 1, to seek prior authorization for procedures scheduled on or after July 1. Authorizations may be submitted online at www.RadMD.com or by phone at 1-833-635-0450.

Interventional Pain Management (IPM) Program Authorizations

This program includes prior authorization for non-emergent outpatient IPM procedures for Ambetter members. Ambetter will oversee the IPM program and continue to be responsible for claims adjudication and medical policies.

Effective July 1, 2022, prior authorization will be required through NIA for the following non-emergent outpatient IPM procedures:

  • Spinal Epidural Injections
  • Paravertebral Facet Joint Injections or Blocks
  • Paravertebral Facet Joint Denervation (Radiofrequency (RF) Neurolysis)
  • Sacroiliac Joint Injections

Authorizations for Additional Cardiac-Related Procedures

NIA currently provides utilization management services for non-emergent, advanced diagnostic imaging services for Ambetter, including CT/CTA, MRI/MRA, PET Scan, Myocardial Perfusion Imaging (MPI), and CCTA.

Effective July 1, 2022, these cardiac-related procedures will also require authorization through NIA:

  • Left Heart Catheterization
  • Cardiac Implantable Devices (defibrillator, pacemaker)

Thank you for the care you provide to your patients – our members – to improve their health and wellness. If you have any questions about these programs, please contact Ambetter Provider Services at 1-833-635-0450.