National Imaging Associates, a Magellan Health Services Company
Welcome to RADMD

BlueCross BlueShield of Tennessee

 

Welcome to the BlueCross BlueShield of Tennessee Health Plan page.  The documents below have been designed to help RadMD users navigates 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, Lori Fink.

MEDICARE plans: Effective 8/5/2024, peer-to-peer discussions must be performed before a final determination has been made on the request. Medicare re-opens are only allowed if the request complies with the CMS definition of a re-open. Providers will continue to have the option to submit an appeal utilizing the health plan’s process. 

Advanced Imaging Program

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