Effective 12/31/2018, Highmark ended the Radiology Management Program supported by NIA. NIA will continue to process appeals for prior authorizations issued in 2018, and retro authorizations for service dates in 2018. For new prior authorizations, and for appeals and retro authorizations for service dates in 2019 and beyond, please see links and guidance under the new Advanced Imaging and Cardiology Services Program.
This link is designed to establish a pathway to clinical consensus on the use of a single or combination of Diagnostic Imaging examinations.
Privileging Appeal Process
Highmark has established a privileging requirement for providers seeking to bill for providing imaging services in the outpatient setting.