Dean Health Plan
Welcome to the Dean 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, Lori Fink.
Evolent will no longer service new authorization requests for Medica/Dean Health Plan and Prevea360 for dates of service October 1, 2024, and beyond. For questions on service dates prior to October 1, 2024, please contact Evolent at 1-833-715-5665. For all additional information, please refer to the Provider Communications page on the Health Plan's website.
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
- Peer to Peer Process - Dean Health Plan
- Peer-to-Peer Process - Prevea360
- Provider Education Presentation
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
Musculoskeletal Program
Dean Health Plan
Prevea360
Musculoskeletal Matrices
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder)
- Utilization Review Matrix (MSK - Spine Surgery)
For access to our Musculoskeletal 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.