Ambetter from NH Healthy Families
Welcome to the Ambetter from NH Healthy Families 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, Seth Cohen.
Effective 9/20/2024, peer-to-peer discussions must be performed before a final determination is made on an authorization request. Reconsideration is not allowed.
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.
Musculoskeletal and Interventional Pain Management Programs - Effective February 1, 2024
- Announcement Letter
- Expanded Partnership
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Recorded Provider Training
- Utilization Review Matrix (Hip, Knee, Shoulder Surgery)
- Utilization Review Matrix (IPM)
- Utilization Review Matrix (Spine Surgery)
For access to our Musculoskeletal tip sheets/checklists, click here.
For access to our Interventional Pain Management 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.