Effective January 1, 2013, certain advanced imaging services for Medicare Advantage beneficiaries will require precertification from National Imaging Associates (NIA) when performed and billed in an outpatient or office location. NIA is an independent company that handles precertification for certain imaging services on behalf of BlueCross.
You can identify Medicare Advantage beneficiaries by the ZCT alpha-prefix on the beneficiary's insurance card. NIA's precertification program for Medicare Advantage will be very similar to the one NIA already uses for our commercial business. In general, non-emergency CTs, MRIs, MRAs and PETs will require precertification. You can find an overview of the NIA program and the instructions on our Radiology Precertification page. For additional information, contact Provider Education at 803-264-4730 or by email at Provider.Education@bcbssc.com.