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National Imaging Associates (NIA)

Absolute Total Care has contracted with National Imaging Associates, Inc. (NIA), an affiliate of Magellan Health Services to provide utilization management for outpatient rehabilitative and habilitative physical medicine services.

The program includes management of prior authorization. This program is consistent with industry-wide efforts ensuring that physical medicine services provided to our members are consistent with nationally recognized clinical guidelines.

Absolute Total Care oversees the NIA program and is responsible for claims adjudication.

Prior authorization is required for the following outpatient therapy services:

  • Physical therapy
  • Speech therapy
  • Occupational therapy

The review is focused on therapy services performed in the following settings:

  • Outpatient office
  • Outpatient hospital

Key Provision

Providers rendering the above services should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim. Please visit the NIA website for more information.

NIA Resources

Absolute Total Care Medicaid Resources

Wellcare Prime by Absolute Total Care Resources

Ambetter from Absolute Total Care Resources

NIA Resources