InsuranceHealth Ins Carriers & MCO's
Aetna NIA Pre-Auth Documents
As of January 1st pre-authorization is required for in-network doctors on fully funded Aetna plans. This process is handled on Aetna’s behalf by a company called NIA. There were a series of webinars presented by NIA on this new process throughout the month of December. If you did not watch one of these webinars a recording is available on their website www.radmd.com. You would need to be registered with NIA and logged in to view the webinar.
NIA has provided a number of instructional and informational documents to assist providers in creating an account, requesting pre-authorization and understanding the process in general. With NIA’s permission these documents are available below:
NIA PowerPoint Presentation – this is a PDF of the PowerPoint slides that made up the webinar presentation from Decembers.
NIA Quick Start Guide – instructions on submitting a pre-authorization request once you have created an account.
NIA Tip Sheet – a list of most of the questions that will be asked when submitting an authorization request either online or by phone.
NIA Checklist – pre-authorization check list.
NIA FAQs – Frequently Asked Questions list.
NIA Utilization Review Matrix – a breakdown and explanation of the CPT code groupings used.
ANJC’s Consolidated NIA-Aetna Contact Information Sheet– contains phone and fax numbers, email and mailing addresses for NIA call center, technical support, provider relations, appeal and claims, etc.