Ambetter from Arkansas Health & Wellness
Welcome to the Ambetter from Arkansas Health & Wellness 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.
Authorization Requirement Changes for Physical Therapy Program
Ambetter from Arkansas Health & Wellness is making changes to Physical Therapy (PT) program authorization requirements for dates of service on and after October 2, 2025.
Effective October 2, 2025, PT prior authorization requests for Ambetter from Arkansas Health & Wellness (Marketplace) members will automatically be approved for ten (10) visits per episode. Prior authorization to obtain these ten visits must be submitted via the Evolent RadMD portal or call center. The initial evaluation still does not require authorization unless treatment is provided during that visit. Subsequent requests beyond the initial 10 visits will follow the current prior authorization process and medical necessity review.
If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:
- Betsy Roberts (Advanced Imaging/Cardiology)
- April Fox (Physical Medicine)
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Utilization Review Matrix - Exchange
- Utilization Review Matrix - Medicare
For access to our Advanced Imaging tip sheets/checklists, click here.
Physical Medicine Program
For access to our Physical Medicine 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.