Partners Health Management
Welcome to the Partners Health Management 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.
PLEASE NOTE: Partners Health Management, consistent with North Carolina Medicaid guidance is waiving prior authorization for the dates of service from July 1, 2024, through February 28, 2025. This transition period for these flexibilities will continue until February 28, 2025, to ensure Providers with contracts will be able to file claims for dates of service from July 1, 2024, through February 28, 2025, without authorization. The No Prior Auth period does not apply to concurrent reviews for inpatient admission. Those should still occur during this time. Prior authorization is required for all dates of service March 1, 2025, and thereafter.
Prior authorization will be required for the following outpatient procedures:
- CT/CTA
- MRI/MRA
- PET Scan
- MUGA Scan
- Nuclear Stress Test
- Echocardiography
If you have any questions about our programs, please contact your dedicated Evolent Provider Relations Manager: Priscilla Singleton
Advanced Imaging Program
- Announcement Letter
- Frequently Asked Questions - Diagnostic Tests and Interventional Procedures
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
- Webinar Flyer
For access to our Advanced Imaging tip sheets/checklists, click here.
Cardiac Program
For access to our Cardiac 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.