Ambetter Health (Iowa)
Welcome to the Ambetter Health (Iowa) 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, Seth Cohen.
Advanced Imaging / Cardiology Program - Effective January 1, 2025
- Frequently Asked Questions
- Provider Education Presentation
- Provider Notification Letter & Webinar Dates
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
For access to our Cardiac tip sheets/checklists, click here.
Interventional Cardiology Program (CarePro) - Effective January 1, 2025
Interventional Pain Management / Musculoskeletal Surgery Program - Effective January 1, 2025
- Frequently Asked Questions
- Provider Education Presentation
- Provider Notification Letter & Webinar Dates (IPM)
- Provider Notification Letter & Webinar Dates (MSK)
- Utilization Review Matrix - IPM
- Utilization Review Matrix - Joint
- Utilization Review Matrix - Spine
For access to our Interventional Pain Management tip sheets/checklists, click here.
For access to our Musculoskeletal tip sheets/checklists, click here.
Medical Oncology / Radiation Oncology Program (CarePro) - Effective January 1, 2025
Physical Medicine Program - Effective January 1, 2025
- Frequently Asked Questions
- Provider Education Presentation
- Provider Notification Letter & Webinar Dates
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.