NIA Announcement

Date: 12/16/20

Dear Provider,

Ambetter from Meridian (Ambetter) is pleased to announce its partnership with National Imaging Associates, Inc. (NIA) to provide utilization management for outpatient rehabilitative and habilitative physical medicine services. This partnership begins January 1, 2021. This program is consistent with industry-wide efforts ensuring that physical medicine services provided to our members are consistent with nationally-recognized clinical guidelines.

Under terms of the agreement between NIA and Ambetter, Ambetter will oversee the physical medicine program and continue to be responsible for claims adjudication and medical policies. NIA will manage outpatient rehabilitative and habilitative services through the existing contractual relationships with Ambetter.

The NIA outpatient rehabilitative and habilitative physical medicine service prior authorization program will begin on January 1, 2021. Any services rendered on or after January 1, 2021 will require authorization. Prior authorization will be available beginning December 21, 2020 for dates of service January 1, 2021 and beyond. Authorizations can be obtained through the website or by calling NIA’s Call Center at 800-424-5686.

Services requiring prior authorization include:

• Physical therapy services
• Occupational therapy services
• Speech therapy services In the coming weeks, you will receive more information from NIA. 

This will include details about training. We appreciate your support and look forward to your assistance in ensuring that Ambetter members receive quality physical, occupational, and speech therapy services delivered in a clinically-appropriate manner. Should you have questions, please contact Ambetter Provider Services at 833-993-2426.

Sincerely,

Ambetter from Meridian