Managed Health Services (MHS)
Welcome to the Managed Health Services (MHS) 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, Andrew Dietz.
Advanced Imaging Program
- Frequently Asked Questions - Pending Approval
- Peer-to-Peer Process
- Provider Education Presentation - Pending Approval
- Quick Reference Guide - Pending Approval
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
Interventional Pain Management (IPM) Program
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
Musculoskeletal Program
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix (Hip, Knee, Shoulder Surgery)
- Utilization Review Matrix (Spine)
For access to our Musculoskeletal tip sheets/checklists, click here.
Physical Medicine Program
- Frequently Asked Questions - Pending Approval
- Provider Education Presentation - Pending Approval
- Quick Reference Guide - Pending Approval
For access to our Physical Medicine tip sheets/checklists, click here.
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
Clinical Guidelines
Evolent adopted the use of the MCG Guidelines® for Indiana Medicaid members. View instructions for accessing MCG Guidelines®. In absence of MCG Guidelines®, Indiana Medicaid uses the below guidelines.
- MRI Low Field
- Spinal Canal MRA
- Unlisted Studies
- Cerebral Perfusion CT
- Follow-up, Limited or Localized CT
Physical Medicine Solutions for Medicaid
Evolent uses Indiana Health Coverage Programs Provider Reference Module for Therapy Services.
Evolent uses Evolent clinical guidelines for Exchange members.
Evolent uses the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) directly from CMS for Medicare members.
Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.