AmeriHealth Caritas Ohio
Welcome to the AmeriHealth Caritas Ohio 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.
Effective April 4, 2025, re-reviews for AmeriHealth Caritas Ohio will be allowed within 14 calendar days from the initial denial date. A re-review can be initiated via clinical document upload on RadMD.com or the peer-to-peer process. Providers will continue to have the option to submit an appeal if the timeframe to initiate a re-review has passed or the case cannot be approved post re-review.
If you have any questions about our programs, please contact your dedicated Evolent Provider Relations Manager, Rachel Vowels.
Advanced Imaging Program
For access to our Advanced Imaging tip sheets/checklists, click here.
Conservative Treatment Forms
For access to our conservative treatment form, click here.
Low Dose Chest CT History Form
Clinical Guidelines
- Clinical Guidelines
- Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.