If your practice orders CT scans, MRIs, or PET scans for patients covered by Molina Healthcare of Illinois — your prior authorization workflow is changing on September 1, 2026.
Molina issued a provider memo on June 25, 2026 announcing the expansion of its partnership with Evolent as the administrator of the Molina Advanced Imaging Program. Beginning September 1, prior authorization requests for advanced imaging services will no longer go through Molina’s standard Availity portal. They will go through Evolent’s RadMD platform at evolent.com/provider-portal.
This affects all three Molina product lines in Illinois — Medicaid, Medicare, and Marketplace — and every practice ordering imaging for Molina members needs to be ready before September 1.
What Is Changing
Starting September 1, 2026, the following advanced imaging services rendered in a provider office, freestanding diagnostic facility, or outpatient hospital for Molina Illinois members will require prior authorization through Evolent:
- CT / CTA — computed tomography and CT angiography
- MRI / MRA — magnetic resonance imaging and angiography
- PET scan — positron emission tomography
This applies to all three Molina Illinois plans:
- Molina Medicaid (HealthChoice Illinois members)
- Molina Medicare
- Molina Marketplace (ACA exchange plans)
- Molina FIDE D-SNP (dual-eligible members)
What You Need to Do Before September 1
Step 1 — Register on the Evolent RadMD portal The Evolent provider portal is at evolent.com/provider-portal. Your practice must register and set up access before September 1. Do not wait until September to register — portal setup takes time and Molina has indicated training resources are available from Evolent staff upon request. Contact Evolent at practicesuccess@evolent.com for training. For portal access assistance: psl@evolent.com or (571) 389-6000.
Step 2 — Update your PA submission workflow for Molina imaging Any staff currently submitting Molina imaging PAs through Availity must be aware that Availity is no longer the submission pathway for CT, MRI, and PET for Molina members after September 1. The RadMD portal provides:
- Real-time authorizations for evidence-based treatment plans
- Eligibility verification directly in the portal before submitting
- Phone intake option when needed
Step 3 — Save the new phone numbers by product line
| Molina Plan | Evolent Phone Number |
|---|---|
| Molina Medicare | (800) 424-6112 |
| Molina FIDE D-SNP | (866) 642-9702 |
| Molina Medicaid | (800) 442-4169 |
| Molina Marketplace | (800) 642-1716 |
Phone intake is available Monday through Friday, 7 a.m. to 7 p.m. Central Time.
Step 4 — Check existing Molina authorizations Authorizations issued by Molina before September 1, 2026 remain valid through their stated expiration date. You do not need to reauthorize studies already approved before September 1 — those authorizations stay in effect.
For new imaging services scheduled on or after September 1, submit all PA requests to Evolent, not Molina.
Why This Change Matters Operationally
Practices with high Molina patient volumes — particularly those ordering significant imaging for Medicaid, Medicare Advantage, or marketplace members — need to treat this as an operational transition, not just an administrative notice.
The risk of missing this deadline is real: a practice that submits a Molina imaging PA through Availity on September 2 may not receive an approval — and a scan performed without proper authorization through the new Evolent pathway will face denial.
The positive side: Evolent’s RadMD platform provides real-time authorization for evidence-based imaging requests — which means faster approvals for straightforward cases compared to many traditional PA workflows.
Questions?
For questions about this change:
- Evolent general inquiries: practicesuccess@evolent.com
- Evolent portal access: psl@evolent.com or (571) 389-6000
- Molina Illinois provider relations: MHILProviderNetworkManagement@MolinaHealthcare.com
You can also review other Illinois Molina provider memos at molinahealthcare.com/providers/il/medicaid/comm/newsupdates.aspx
Read the Full Illinois Billing Guide
This update affects Molina Healthcare of Illinois — one of the six active HealthChoice Illinois MCOs. For complete information on all Illinois Medicaid MCOs, payer IDs, eligibility verification, timely filing limits, and provider enrollment requirements, read our complete Illinois billing guide:
👉 Medical Billing and Credentialing in Illinois: A Complete Guide for Providers in 2026
At ClaimsXperts, we monitor payer bulletins and policy changes across all major Illinois MCOs so your practice stays ahead of changes that affect claims reimbursement. Contact us at rcmmasters.com/#contactus to learn how we can support your Illinois billing operations.
Source: Molina Healthcare of Illinois Provider Memo — Evolent UM Expanding to Advanced Imaging, issued June 25, 2026.
ClaimsXperts is a Revenue Cycle Management company based in Frisco, TX, serving medical practices across the United States.
