RADMD | Meridian Health Plan of Illinois

Welcome to the Meridian Health Plan of Illinois 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.

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 - Medicaid

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

Advanced Imaging Program - Medicare/Medicaid

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

Cardiac Program - Medicare/Medicaid

Frequently Asked Questions

For access to our Cardiac tip sheets/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.

Physical Medicine

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

YouthCare HealthChoice Illinois

Conservative Treatment Forms

For access to our conservative treatment forms, click here.

Clinical Guidelines

Clinical Guidelines
Click here to view Evolent's 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.

Meridian Health Plan of Illinois