MeridianHealth (Medicaid) and WellCare (Medicare) - NEW Authorization Vendor Change

Please see the attached fax notification that is going to be sent to offices regarding the prior authorization vendor change for MeridianHealth (Medicaid) and WellCare (Medicare). This change is going to go into place effective 4/1/21.

National Imaging Associates, Inc. (NIA)

• www.RadMD.com
• 1-866-842-1767 (Medicaid)
• 1-800-424-5388 (Medicare)

As a reminder, for Ambetter members

This link will provide more information on Ambetter (Commercial) : https://www.ambettermeridian.com/provider-resources/manuals-and-forms/pre-auth.html

HealthHelp and eviCore will no longer be managing services for the Meridian plans migrating to Centene platform on 1/1/21. This includes the legacy Meridian HIX and MI MMP. Any services that do not fall within the scope of the Centene vendors (i.e. NIA, New Century) will be managed in house as they currently are. H3/Innovista will also no longer be managing the MI MMP membership effective 1/1/21, they will continue to manage H5475(DSNP/MAPD) membership.

Here is the information related to NIA, New Century, TurningPoint

As of January 1st 2021: