Ambetter from Buckeye Health Plan

Welcome to the Ambetter from Buckeye 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 managing. 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 questions about our programs, please contact Evolent at [email protected].
Reminder: ICHRA members can easily be recognized by the "Solutions" section on the member ID card:
Program Updates:
Effective November 3, 2026, Evolent will perform site of care (SoC) review for applicable musculoskeletal (MSK) surgeries for Buckeye Health Plan Exchange members. To review SoC Guidelines refer to the Clinical Guidelines section on this page or click here.
Advanced Imaging Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - 2026 (Effective 04.01.2026)
- Utilization Review Matrix - 2026 (01.01.2026 - 03.31.2026)
For access to our Advanced Imaging tip sheets/checklists, click here.
Musculoskeletal Program
- Frequently Asked Questions
- Utilization Review Matrix - (Hip, Knee, and Shoulder Surgery) - 2026
- Utilization Review Matrix - (Spine Surgery) - 2026
- Provider Education Presentation
- MSK Surgery Requests with SoC Workflow Presentation- Effective 11.03.2026
For access to our Musculoskeletal tip sheets/checklists, click here.
Physical Medicine Program
For access to our Physical Medicine 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
- Clinical Guidelines
- MSK Site of Care (SoC) Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.

