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

CareSource Ohio

Welcome to the CareSource Ohio 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.

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. 

CareSource Ohio (Medicaid)

Advanced Imaging Program

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

CareSource Ohio (Medicare)

Advanced Imaging Program

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

CareSource Marketplace Ohio (Exchange)

Advanced Imaging Program

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

CareSource Marketplace Ohio (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 Clinical Guidelines

Evolent uses for Ohio 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.