RADMD | Highmark Wholecare (Gateway Health and Gateway Health Medicare Assured)

Welcome to the Highmark Wholecare (Gateway Health and Gateway Health Medicare Assured) 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:

RBM/Cardiac - PA/WV/KY/NC/OH - Lori Fink

Physical Medicine and Musculoskeletal - Seth Cohen

Advanced Imaging Program

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

Cardiac Program

Frequently Asked Questions

For access to our Cardiac tip sheets/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.

Physical Medicine Program

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

Conservative Treatment Forms

For access to our conservative treatment forms, click here.

Low Dose Chest CT History Form

Clinical Guidelines

Clinical Guidelines
Physical Medicine Guidelines
Evolent adopted the use of MCG Guidelines® for its Physical Medicine product. View instructions for accessing MCG Guidelines®.
Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.

Highmark Wholecare (Gateway Health and Gateway Health Medicare Assured)