CareSource Ohio
Welcome to the CareSource Ohio Health Plan page. The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent is responsible for. Additional process-specific training tools and modules can be found via links on the Resources tab at the top of the screen.
If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:
- Rachel Vowels-Delk (Advanced Imaging/Cardiology)
CareSource Ohio (Medicare-Medicaid)
Advanced Imaging Program
- Frequently Asked Questions
- Provider Education Presentation
- Scope of Service
- Utilization Review Matrix - Medicaid
- Utilization Review Matrix - Medicare
For access to our Advanced Imaging tip sheets/checklists, click here.
CareSource Marketplace Ohio (Marketplace)
Advanced and Cardiac Imaging Program
- Cardiac Frequently Asked Questions
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
For access to our Cardiac tip sheets/checklists, click here.
Peer-to-Peer Process
For access to our peer-to-peer process, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
Evolent uses for Ohio Medicare Members the (Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) directly from CMS.
Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.