Capital Blue Cross
Welcome to the Capital Blue Cross 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 Evolent Provider Relations Manager, Lori Fink.
Advanced Imaging and Cardiac Programs
- Cardiac Frequently Asked Questions
- Peer-to-Peer Process
- Quick Reference Guide - Clinical Validation of Records
- Utilization Review Matrix (Fully Insured)
- Utilization Review Matrix (Self-Funded)
For access to our Advanced Imaging tip sheets/checklists, click here.
For access to our Cardiac tip sheets/checklists, click here.
Radiation Oncology Program
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Radiation Oncology checklists/clinical guidelines/coding standards, 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.