Evolent (formerly National Imaging Associates)

Harvard Pilgrim has a partnership with Evolent (formerly National Imaging Associates, Inc./NIA) to oversee prior authorization programs for certain services, including cardiac diagnostic tests and interventional procedures; diagnostic imaging; sleep studies; hip, knee, and shoulder surgery; spine surgery and cervical spine procedures; and outpatient interventional spine pain management services. You’ll find some resources and education materials for these programs — including utilization review matrices with coding — on Evolent’s dedicted Harvard Pilgrim Health Care webpage.

Contact Evolent online or by telephone.

Online: www.radmd.com (general); www1.radmd.com/all-health-plans/harvard-pilgrim-healthcare (dedicated Harvard Pilgrim page)

Telephone: 800-642-7543

Authorization status and approved transaction numbers are also available to servicing providers through HPHConnect and NEHEN. Status and transaction numbers can be accessed through Evolent’s website at www.radmd.com.