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  • Welcome to RadMD. com | RADMD
    RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource
  • 2024 NIA Clinical Guidelines For Medical Necessity Review
    Preamble NIA is committed to the philosophy of supporting safe and effective treatment for patients The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging These criteria are designed to guide both providers and reviewers to the most appropriate diagnostic tests based on a patient’s unique circumstances In all cases, clinical judgment consistent
  • National Imaging Associates, Inc. (NIA)* Radiation Oncology Solutions . . .
    NIA's guidelines for Radiation Oncology Solutions services have been developed from practice experience, literature reviews, specialty criteria sets and empirical data
  • RadMD: Online Access to Evolent
    RadMD is a user-friendly, real-time alternative or supplement to our call center Our system provides instant access to much of the prior authorization information that our call center staff provides Primarily designed for Imaging Facilities, Hospitals and Health Plans, logging on to RadMD can provide up-to-the-hour information on a member's authorization, including date called, date approved
  • National Imaging Associates Inc. (NIA)* Medical Specialty . . . - RadMD
    National Imaging Associates Inc (NIA)* Medical Specialty Solutions Frequently Asked Questions (FAQ’s) For Tufts Health Plan Providers Question Answer GENERAL Why did Tufts Health Plan implement a Medical Specialty Solutions Program? Tufts Health Plan implemented a Medical Specialty Solutions Program to ensure clinically appropriate care and manage the increasing utilization of the following
  • 2025 Evolent Clinical Guidelines for Medical Necessity Review
    Guideline Development Process These medical necessity criteria were developed by Evolent for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups Evolent’s guidelines are
  • RADMD | Appeals
    For health plans where Evolent manages clinical appeals, providers can submit appeals directly through RadMD If an authorization request is denied, the Initiate Appeal option will appear at the top of the Exam Request Verification Details screen When Initiate Appeal is selected, you will be guided through a series of clinical questions and prompted to upload supporting clinical documentation
  • National Imaging Associates, Inc. * 2024 NIA Clinical Guidelines For . . .
    Preamble NIA is committed to the philosophy of supporting safe and effective treatment for patients The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging These criteria are designed to guide both providers and reviewers to the most appropriate diagnostic tests based on a patient’s unique circumstances In all cases, clinical judgment consistent
  • Clinical Guidelines Other Resources - RadMD
    You can access our clinical guidelines, checklists and other tools for each solution below: Advanced Imaging Cardiac Genetic Testing Interventional Pain Management Musculoskeletal Surgery Physical Medicine Radiation Oncology Sleep For health plan specific clinical guidelines, CMS guidelines that include Local and National Coverage Determinations (LCDs and NCDs), educational documents and other
  • National Imaging Associates, Inc. (NIA) Medical Specialty . . . - RadMD
    National Imaging Associates, Inc (NIA) Medical Specialty Solutions Frequently Asked Questions (FAQ) For Sunshine Health and Children's Medical Services Health Plan Providers Question Answer GENERAL Why did Sunshine Health and Children's Medical Services Health Plan implement a Medical Specialty Solutions Program? The Sunshine Health and Children's Medical Services Health Plan implemented a





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