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

CommunityCare Oklahoma

Welcome to the CommunityCare Oklahoma 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.

If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:

Program Update:  Effective March 1, 2026, CommunityCare of Oklahoma Advanced Imaging and Diagnostic Cardiology authorization requests will include updated questions around site of service selection when determining the rendering provider for the imaging procedure. When a request is submitted with a hospital as the selected setting, providers will be prompted to provide clinical justification for using the hospital setting or select a non-hospital imaging facility. For questions, please contact your Provider Engagement Manager or email [email protected].

CommunityCare Oklahoma Continuity of Care: For the first 90 days after a member’s enrollment, an active course of treatment that began before the member joined CommunityCare may be eligible for continuity of care. For services that are part of an active, previously established plan of care (for example, post-operative therapy or other ongoing treatment that started under the prior plan), please call the call center at the number below and indicate that you are requesting continuity of care for a new enrollee. Our team will determine whether the service qualifies for continuity of care and, when it does, will process the authorization consistent with Medicare Advantage continuity of care requirements.  

CommunityCare Oklahoma (Commercial) 888.899.7804
CommunityCare Oklahoma (Medicare) 888.899.7803

 

Advanced Imaging and Cardiology Program

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

Musculoskeletal Surgery and Interventional Pain Management Program

Note:  Per CMS guidance, one to two levels, either unilateral or bilateral, are allowed per session per spine region. Three and four level procedures are not medically necessary and therefore are non-covered. An Evolent approval is not a guarantee of payment. Payment for procedures is contingent on the patient’s eligibility and plan limitations, if any, at the time the service is delivered.

For access to our Musculoskeletal Surgery tip sheets/checklists, click here.

For access to our Interventional Pain Management tip sheets/checklists, click here.

Physical Medicine Program

For access to our Physical Medicine tip sheets/checklists, click here.

Peer-to-Peer Process  

For access to our peer-to-peer process, click here.

Conservative Treatment Forms  

For access to our conservative treatment forms, click here.

Clinical Guidelines