Welcome to the Wellcare of Tennessee Medicare 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 Relations Manager:  

• Brandi Patterson (Advanced Imaging/Cardiology)
• April Fox (Interventional Pain Management/Musculoskeletal/Physical Medicine)

Musculoskeletal Program and Interventional Pain Management Program

• Frequently Asked Questions
• Provider Education Presentation

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

Physical Medicine Program

• Frequently Asked Questions
• Provider Education Presentation

Update for Wellcare Tennessee:

• Home Health Providers submitting claims utilization G-Codes for all home therapy services are excluded from the Physical Medicine Program

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

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

Clinical Guidelines

• Clinical Guidelines
• Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.