Tufts Health Plan
Welcome to the Tufts Health Plan 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, Seth Cohen.
Massachusetts Imaging Prior Authorization Form
News
Beginning 1/1/25, providers submitting advanced imaging and cardiology prior authorization requests will be required to submit supporting clinical documentation when the request pends for review.
Advanced Imaging and Cardiology Services
- Cardiology Frequently Asked Questions
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix
For access to our Advanced Imaging tip sheets/checklists, click here.
For access to our Cardiac tip sheets/checklists, click here.
Musculoskeletal and Interventional Pain Management Programs
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide
- Utilization Review Matrix (IPM)
- Utilization Review Matrix (MSK - Hip, Knee and Shoulder)
- Utilization Review Matrix (MSK - Spine Surgery)
For access to our Musculoskeletal tip sheets/checklists, click here.
For access to our Interventional Pain Management 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.