Evolent
Nebraska Total Care has contracted with Evolent for radiology management.
Radiology
The radiology program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services.
Nebraska Total Care oversees the Evolent program and is responsible for claims adjudication. Evolent manages non-emergent outpatient imaging/radiology services through contractual relationships with free-standing facilities.
Prior authorization is required for the following outpatient radiology procedures:
- CT/CTA
- MRI/MRA
- PET Scan
Key Provisions
Providers rendering the above services should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim.
Go to the Evolent website for more information.
- Evolent Cardiac Checklist (PDF)
- Evolent Cardiac Tip Sheet (PDF)
- Evolent Pediatric Imaging Tip Sheet (PDF)
- Evolent Prior Authorization Tool Resource (PDF)
- Evolent RadMD for Imaging Providers (PDF)
- Evolent Tip Sheet (PDF)
- Evolent RadMD Quick Start Guide (PDF)
- Evolent Utilization Review Matrix (PDF)
- Sign up for Paperless Notification from Evolent (PDF)
- Additional Evolent References