Evolent (formerly National Imaging Associates) ― Diagnostic Imaging Services

AmeriHealth Caritas Pennsylvania Community HealthChoices has an agreement with Evolent (formerly National Imaging Services [NIA]) to manage diagnostic imaging services such as MR/CT/PET.

The program will require prior authorization from Evolent for nonemergent outpatient:

  • CT/CTA
  • CCTA
  • PET scan
  • MUGA scan
  • Myocardial perfusion imaging (MPI)

Providers can request prior authorization online or by calling Evolent at 1-800-424-5657.

The physician ordering the procedures noted above is responsible for obtaining prior authorization. The rendering facility must ensure that prior authorization was obtained.

We recommend that you develop a process to ensure that the appropriate authorization number(s) has been obtained. Payment to the ordering physician and rendering facility will be denied for procedures performed without necessary authorization.