Presbyterian Health Plan
Welcome to the Presbyterian Health Plan 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.
If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:
- April Fox (Musculoskeletal)
PRESBYTERIAN HEALTH PLAN (PHP): Effective April 1, 2025, Evolent will no longer service PHP for RBM and Cardiac Imaging. Prior authorization submission instructions can be located at PHP’s website - https://www.phs.org/providers/authorizations. Evolent continues to service PHP’s Musculoskeletal Surgery (Spine) services.
Musculoskeletal Program
- Authorization Process for Expedited/Urgent Requests
- Checklist - Spine Surgery
- Frequently Asked Questions
- Provider Education Presentation
- Utilization Review Matrix (Spine) - 2025
- Utilization Review Matrix (Spine) - 2026
For access to our Musculoskeletal tip sheets/checklists, click here.
Prior Authorization Form
Peer-to-Peer Process
For access to our peer-to-peer process, 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.