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

Harvard Pilgrim Health Care

 

Welcome to the Harvard Pilgrim Health Care Health Plan 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.

Effective January 1, 2026, within the first 90 days of the member's eligibility, if you need an authorization and have an authorization from the member's previous health plan, please call the call center and indicate that you have a Point32Health continuity of care case to initiate an authorization.

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

  • Lori Fink (Advanced Imaging/Cardiology/Sleep)
  • Mara Grimm (Interventional Pain Management/Musculoskeletal)

Massachusetts Imaging Prior Authorization Form

State Authorizations and Requirements

Advanced Imaging, Diagnostic Cardiology and Sleep Program

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

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

For access to our Sleep Solutions checklists, click here.

Musculoskeletal and Interventional Pain Management Program

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

For access to our Interventional Pain Management 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

  • Clinical Guidelines
  • Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.