Updated: Genetic and Molecular Testing - Delegation of Utilization Review to National Imaging Associates (NIA)
Date: 10/14/22
Superior HealthPlan previously provided notice of the planned delegation of utilization review to National Imaging Associates, Inc. (NIA) for genetic and molecular testing services for Superior Medicaid (STAR, STAR+PLUS, STAR Health and STAR Kids), CHIP, STAR+PLUS Medicare-Medicaid Plan (MMP), Ambetter from Superior HealthPlan (Marketplace) and Wellcare By Allwell (HMO and HMO DSNP) members.
The effective date for the transition to NIA to perform utilization review for genetic and molecular testing has been extended to November 1, 2022. Beginning October 24, 2022, prior authorization requests can be submitted to NIA for tests performed on or after November 1, 2022.
Prior authorization requests can be submitted electronically to NIA at www.RadMD.com, by calling 1-800-642-7554 or through faxing 1-800-784-6864.
Providers are encouraged to review the clinical policies that will be utilized by NIA in advance of the genetic and molecular testing utilization review. To access NIA’s genetic testing clinical policies, please visit NIA’s Genetic Testing Clinical Guidelines webpage.
Training Opportunities
To learn more about NIA’s policies, procedures and the submission of prior authorization requests for genetic and molecular testing on or after November 1, 2022, providers are encouraged to attend one of the upcoming training events below:
- Tuesday, October 25, 2022 (9:00 a.m. – 10:00 a.m.): REGISTER NOW
- Thursday, October 27, 2022 (12:00 p.m. – 1:00 p.m.): REGISTER NOW
- Wednesday, November 2, 2022 (9:00 a.m. – 10:00 p.m.): REGISTER NOW
- Wednesday November 9, 2022 (12:00 p.m. – 1:00 p.m.): REGISTER NOW
To find additional training opportunities, please visit the Superior Provider Training Calendar.
For questions related to this communication, please contact your assigned Account Manager.