Delegation of Joint/Spine Surgery and Interventional Cardiology Services to Evolent
Neighborhood Health Plan of Rhode Island delegates medical management (prior authorization) for specified non-emergent joint/spine surgeries and interventional cardiology services for Medicaid and Medicare members to Evolent; Commercial line is not included.
Evolent will manage prior authorization for Joint/Spine Surgery and Interventional Cardiology services for Neighborhood Medicaid and Medicare lines of business.
Commercial line of business is excluded from the delegation.
Emergent Interventional Cardiology services are excluded from prior authorization.
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