RADMD | Ambetter from Sunflower Health Plan

Welcome to the Ambetter from Sunflower Health Plan 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.

Please note:

Starting on July 12, 2021, Sunflower Health Plan reviews all Medicaid appeals. All Medicaid advanced imaging and physical medicine authorization requests will still be processed by Evolent. In the event of an adverse benefit determination, please follow the instructions in the letter and send your appeal request directly to Sunflower Health Plan. This will ensure the appeal is handled and processed in a timely manner.

Sunflower Appeals Department

8325 Lenexa Drive, Suite 410

Lenexa, KS 66214

Phone number: 1-877-644-4623, TTY 711

Fax: 1-888-453-4755

Advanced Imaging Program

For access to our Advanced Imaging tip sheets/checklists, click here.

Interventional Pain Management Program - Effective 4/1/2024

For access to our Interventional Pain Management tip sheets/checklists, click here.

Musculoskeletal Program - Effective 4/1/2024

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.

Ambetter from Sunflower Health Plan