RADMD | Ambetter from Superior HealthPlan

Welcome to the Ambetter from Superior HealthPlan 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 Provider Relations Manager: Charles Allison.

Advanced Imaging Program

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

Genetic Testing Program

For access to our Genetic Testing clinical guidelines, click here.

Interventional Pain Management Program

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

Musculoskeletal Program - Effective January 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 Superior HealthPlan