Alliance Health
Welcome to the Alliance Health 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.
PLEASE NOTE: Alliance Health, with North Carolina Medicaid guidance is waiving prior authorization for the dates of service from July 1, 2024, through January 31, 2025. To ensure continuous care for members during the transition, Alliance is extending certain policy flexibilities originally scheduled to expire September 30, 2024. The transition period for these flexibilities will continue until January 31, 2025.
If you have any questions about our programs, please contact your dedicated Evolent Provider Relations Manager: Priscilla Singleton
Advanced Imaging Program
- Announcement Letter
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix - 2024
- Utilization Review Matrix - 2025
For access to our Advanced Imaging tip sheets/checklists, click here.
Cardiac Program
For access to our Cardiac tip sheets/checklists, click here.
Musculoskeletal Program
- Announcement Letter
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix (Hip, Knee, Shoulder) - 2024
- Utilization Review Matrix (Hip, Knee, Shoulder) - 2025
- Utilization Review Matrix (Spine) - 2024
- Utilization Review Matrix (Spine) - 2025
For access to our Musculoskeletal tip sheets/checklists, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Low Dose Chest CT History Form
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.