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 (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, Seth Cohen. 

For dates of service beginning June 24, 2019, the following cardiac procedures will require prior authorization for our commercial members: Cardiac Resynchronization Therapy (CRT), Implantable Cardioverter Defibrillator (ICD), Pacemaker Insertion, Transthoracic Echocardiography (TTE), Transesophageal Echocardiography (TEE), Stress Echocardiography, Heart Catheterization. (These procedures began requiring prior authorization for our Medicare Advantage members on Jan. 1, 2019).

Massachusetts Imaging Prior Authorization Form

State Authorizations and Requirements

Advanced Imaging, Cardiac and Sleep Programs

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 Programs

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

For access to our Interventional Pain Management 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.