Ambetter from MHS
Welcome to the Ambetter from MHS page. The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent (formerly National Imaging Associates, Inc.) 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, Andrew Dietz.
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
Interventional Pain Management Program
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Interventional Pain Management tip sheets/checklists, click here.
Musculoskeletal Program
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix (Hip, Knee, Shoulder Surgery)
- Utilization Review Matrix (Spine Surgery)
For access to our Musculoskeletal 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.
Clinical Guidelines
- Clinical Guidelines
- Click here to view Evolent's Physical Medicine guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.