Ambetter of Oklahoma

Welcome to the Ambetter of Oklahoma page. The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent is responsible for managing. 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 questions about our programs, please contact Evolent at [email protected].
Effective January 1, 2026, Ambetter of Oklahoma is adding Individual Coverage Health Reimbursement Arrangement (ICHRA) to their current programs with Evolent for the Exchange line of business.
Advanced Imaging and Cardiology Program
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix - 2026 (Effective 05.01.2026)
- Utilization Review Matrix - 2026 (Effective 01.01.2026-04.30.2026)
For access to our Advanced Imaging tip sheets/checklists, click here.
For access to our Cardiac tip sheets/checklists, click here.
Musculoskeletal and Interventional Pain Management Programs
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix (IPM) - 2026
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder) - 2026
- Utilization Review Matrix (MSK - Spine Surgery) - 2026
For access to our Musculoskeletal Surgery 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.
Peer-to-Peer Process
For access to our peer-to-peer process, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.

