CareSource Indiana
Welcome to the CareSource Indiana Health Plan 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, Mara Grimm.
CareSource Indiana (Medicaid)
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
CareSource Indiana (Medicare)
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
CareSource Marketplace Indiana (Exchange)
Advanced Imaging Program
- Frequently Asked Questions
- Peer-to-Peer Process
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
CareSource Marketplace Indiana (Exchange)
Cardiac Program
For access to our Cardiac tip sheets/checklists, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
Evolent adopted the use of MCG Guidelines® for Indiana Medicaid members. View instructions for accessing MCG Guidelines®. In absence of MCG Guidelines®, CareSource Indiana uses the below Guidelines:
- MRI Low Field
- Unlisted Studies
- Cerebral Perfusion CT
- MRA Spinal Canal and Contents (refer to CMS NCD 220.2 for Magnetic Resonance Imaging)
- Follow up, Limited, or Localized CT (refer to CMS NCD 220.1 for Computer Tomography)
Evolent uses for Indiana Exchange members Evolent Clinical Guidelines.
Evolent uses for Indiana Medicare Members the (Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) directly from CMS.
Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.