National Imaging Associates (NIA)

YouthCare has contracted with National Imaging Associates, Inc. (NIA), NIA is a subsidiary of Evolent Health LLC, for radiology benefit management.

The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services.

YouthCare oversees the NIA program and is responsible for claims adjudication. NIA manages non-emergent outpatient imaging/radiology services through contractual relationships with free-standing facilities.

Effective April 1, 2021 prior authorization is required for the following outpatient radiology procedures:

• CT/CTA/CCTA
• MRI/MRA
• PET Scan

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.

Go to the NIA website for more information.

NIA Resources

• How to Upload Document without a RadMD Login (PDF)
• YouthCare NIA HealthChoice Illinois Webinar

Information last updated: March 9, 2021