Radiology Management Program

Program Information
Highmark Delaware utilizes the radiology management services of National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health, Inc., for non-emergent, high-tech outpatient radiology services rendered to members enrolled in Highmark Delaware health plans.

Prior Authorization
Advanced Imaging and Cardiology Services authorization requests for 2018 dates of service must be submitted to NIA before Dec. 31, 2018. Retro authorizations and/or appeals for dates of service in calendar year 2018 must be submitted to NIA no later than June 30, 2019. NIA medical policy guidelines for the applicable dates of service in 2018 will apply.

All requests for 2019 dates of service must be submitted to eviCore healthcare (eviCore).

Note: Highmark Delaware is partnering with eviCore for a new Advanced Imaging and Cardiology Services Program, effective Jan. 1, 2019. The eviCore program will replace the NIA Radiology Management Program. However, eviCore will oversee the same Highmark Delaware members and prior authorize largely the same set of advanced diagnostic imaging and cardiology services along with new additional services.

To learn more about the new eviCore Advanced Imaging and Cardiology Services Program, please go to the Advanced Imaging and Cardiology Services Program page under Care Management Programs on the Provider Resource Center.

Privileging Application and Requirements (Effective 12/14/18, NIA will no longer process new privileging applications.)
Highmark Blue Cross Blue Shield Delaware, with the assistance of National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health, Inc., has implemented a new imaging privileging process. On this page you will find Highmark Delaware's privileging requirements and online application instructions.

Radiation Safety Awareness
To protect our members, and assist our network physicians in doing the same, Highmark is launching a Radiation Safety Awareness Project. This project will identify for you those members who have been exposed to a threshold amount of ionizing radiation.

Last updated on 2/7/2019

 

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