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State Health Plan: New Precertification Procedures for Advanced Imaging Services

September 23, 2009

Effective January 1, 2010, certain advanced imaging services for State Health Plan members will require precertification from National Imaging Associates (NIA) when performed and billed in an outpatient or office location. On behalf of BlueCross, NIA handles precertification for certain imaging services. NIA is an independent company. You can identify State Health Plan members by the "ZCS" alpha-prefix on the member's insurance card. The precertification program that NIA will employ on behalf of the State's Employee Insurance Program (EIP) will be very similar to that already used by NIA on behalf of BlueCross BlueShield of South Carolina for its commercial business. In general, non-emergency CTs, MRIs, MRAs and PETs will require precertification. An overview of the NIA program and the instructions may be reviewed on the Radiology Precertification page. For additional information you can contact your Provider Education representative at 803-264-4730 or by e-mail at Provider.Education@bcbssc.com.

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