Reference Materials

• 2023 Provider & Billing Manual (PDF)
  
• 2022 Provider & Billing Manual (PDF)
• 2021 Provider & Billing Manual (PDF)
  
• Quick Reference Guide (PDF)
• Prior Authorization Guide (PDF)
• Prior Auths Removed 3-31-21 (PDF)
• Secure Portal (PDF)
• Payspan (PDF)
• ICD-10 Information
• Electronic Transactions (PDF)
• Ambulatory Surgery Center Optimization Codes (PDF)
• NIA Physical Medicine Request Checklist (PDF)
• NIA Physical Medicine Services FAQs (PDF)
• NIA Expanded Partnership Provider Letter (PDF)
• National Imaging Associates, Inc. (NIA)’s Peer-to-Peer Process (PDF)
  
• Ambetter Prior Authorization Changes - Effective 10/01/2021 (PDF)
  
• Ambetter Prior Authorization Change Notification Changes Effective 11/1/21 (PDF)

Medical Management/Behavioral Health

• Pre-Auth Needed?
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)
• CDMS Barcoded Form Disclosure (PDF)
• Grievance and Appeals
• BH - Discharge Consultation Form (PDF)
• BH - SMART Goals Fact Sheet (PDF)

Claims and Claim Payment

• Claim Dispute Form (PDF)
• No Surprises Act Open Negotiation Form (PDF)
  

Quality

• Practice Guidelines (PDF)
• Quality Improvement (QI)
• Notification of Pregnancy Form (PDF)