Business ProfileforNational Imaging Associates, Inc.

My son’s insurance company uses NIA to determine eligibility for patient procedures. My son was initially hospitalized for a brain injury, but then developed meningitis and therefore a lumbar drain and treatment were put in place. All of this is documented in the notes of the paperwork given to NIA for review. The “Physician Reviewer” determined my son was ineligible for the requested Lumbar Spine CT. Based on guidelines set forth for determining eligibility, my son 100% qualifies for an approval of the Lumbar Spine CT. I called NIA to speak to them about the decision of this “Physician Reviewer” and I eventually spoke with a manager named ******. We talked in circles because she seems like the type of person who is not mature enough in life to accept responsibility for mistakes. ****** politely argued with me about how she felt this was a valid decision but because we kept taking in circles, she claimed to have spoken to a second “Physician Reviewer” while I was on hold. When Katina came back on the line, she let me know the second opinion was upheld by the first one. NIA sent me a packet of information on the denial, including my sons medical records and all documentation of both his head injury AND the lumbar drain and issues he had while hospitalized. My son also obviously is entitled to an approval simply based on the fact that he has a “new footnote” and that is solely a reason in itself to warrant an approval of the Lumbar Spine CT. I do not believe this company to be competent enough to make such determinations on behalf of insurance companies, especially when patients are legitimately in need of services or procedures. SHAME ON NIA!