WellCare of North Carolina

Welcome to the WellCare of North Carolina page.  The Medicaid (WellCare of North Carolina), Medicare (Wellcare of North Carolina) and Exchange (WellCare of North Carolina by Celtic Insurance Company) 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:

• Brandi Patterson (Advanced Imaging/Cardiology)
• Karla Lowery (Interventional Pain Management/Musculoskeletal/Physical Medicine)

Any services requested that are listed on the IFSP form will be redirected back to Medicaid Direct for children less than 3 years of age. Evolent will not process these requests.  

MEDICAID PROGRAM SUNSET: Effective April 1, 2026, Evolent will no longer manage prior authorizations for any specialty for Wellcare North Carolina Medicaid members. Please contact the health plan directly to confirm prior authorization requirements and processes to follow starting April 1st.

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.

Low Dose Chest CT History Form  

Low Dose Chest CT History Form