Ambetter from Coordinated Care
Welcome to the Ambetter from Coordinated Care 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 Relations Manager, Sarai Mansanarez.
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Utilization Review Matrix - 2024
- Utilization Review Matrix - 2025
For access to our Advanced Imaging tip sheets/checklists, click here.
Interventional Pain Management Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - 2024
- Utilization Review Matrix - 2025
For access to our Interventional Pain Management tip sheets/checklists, click here.
Musculoskeletal Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - Hip, Knee and Shoulder - 2024
- Utilization Review Matrix - Hip, Knee and Shoulder - 2025
- Utilization Review Matrix - Spine Surgery - 2024
- Utilization Review Matrix - Spine Surgery - 2025
For access to our Musculoskeletal tip sheets/checklists, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.