Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status Tune into our recent podcast episode with eviCore's post-CAM program specialists Dr. Chanta Van Laanen, Dr. Laura Beitz-Walters and Dr. Mark Leichter to learn more. Thank you for using eviCores website today! As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, Q1: Overall, how satisfied are you with eviCores website? "eviCore has over 1,100 doctors, therapists and nurses from a variety of specialties. Prior authorization requests for our Blue Cross Medicare Advantage (PPO)SM(MA PPO), Blue Cross Community Health PlansSM(BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SMmembers can be submitted to eviCore in two ways. What services are managed through the Musculoskeletal Pain Management Program? If the provider or member doesnt get prior authorization for out-of-network services, the claim may be denied. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Behavioral Health IP PA - IVR Caller Guide, Behavioral Health OP PA - IVR Caller Guide, Inpatient Preauthorization - IVR Caller Guide, Outpatient Preauthorization - IVR Caller Guide, Preauthorization: Check Request Status - IVR Caller Guide, Utilization Management Process Overview (Commercial), Patients medical or behavioral health condition, Date of service, estimated length of stay (if the patient is being admitted), Provider name, address and National Provider Identifier (NPI), Government Programs 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI). You might find that the answer is simpler than you think! Learn more from eviCore experts Sid Govindan, MD and John Young on how eviCore is applying these technologies to evolve the prior authorization process. Call Center: eviCore's is available from 7 a.m. to 7 p.m. eviCore is committed to providing an evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics, and sensitivity to the needs of everyone involved across the healthcare continuum. Echocardiograms also just so happen to be one of the most common inappropriately ordered tests. Forgot Password? Online forms from eviCore's carriers hub MENU PROVIDERS About; Solutions. . Annual Utilization Statistics | Please complete the Dental Specialty Referral Request Form and fax to 480-350-2217, email to: HCHdentaldeptHCA@azblue.com, or mail to: BCBSAZ Health Choice, Inc. Attn: Dental Prior Authorization. . Provider Contacts | Provider | Premera Blue Cross Sessions offered May and June. PPO members You don't need to worry about referrals. What is included in the Cardiovascular solution? Benefits can vary; always confirm member coverage. Eligibility Verification Providers should verify member eligibility prior to requesting/providing services. eviCore made it easy to complete my primary task online. As a valued user of our website, wed appreciate your feedback to help us improve your website experience. Emily Coe, PhD interviews eviCore's Dr. Mary Kay Barton, Sr. Medical Director, Medical Oncology, and Dr. Gary Jones, Associate Medical Director, Medical Oncology, for an enlightening conversation on clinical trials in pediatric and adult oncology, treatment innovations, and more. Use the Prior Authorization Crosswalk Table when you have an approved prior authorization for treating a UnitedHealthcare commercial member and need to provide an additional or different service. The table will help you determine if you can use the approved prior authorization, modify the original or request a new one. What is included in the Medical Oncology program? Description. Manage practice information, access staff training and complete attestation requirements. Specialized therapies such as chiropractic, acupuncture, and physical therapy are cost effective, and can provide improved outcomes for chronic pain patients. Simply visit the eviCores Providers Hub page and select the health plan and solution option for your case in the training section. To contact Customer Care, please call the phone number on the back of your Member ID Card. Fax: If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments. The Role of Prior Authorization at eviCore | Evernorth eviCore made it easy to complete my primary task online. eviCore intelliPath . Call 1-888-233-8158 from 8:00 a.m. to 9:00 p.m., Eastern, Monday through Friday. Provider costs are reduced and decisions are communicated in real time, reducing delays. In this weeks podcast, Dr. Torelli and Liz Avila discuss why its important for all patients to learn more about their care. Remember, member benefits and review requirements will vary based on service/drug being rendered and individual/group policy elections. Phone - Call eviCore toll-free at 855-252-1117 . Please click here to register for an account. What do I do if a members eligibility is incorrect or not on file? Clinical Resourcespage on theBCBSTX Medicaidwebsite. Login | Providers | Univera Healthcare See Clinical Corner for services that require Preauthorization. Moreover, eviCore is the only company in the industry with dedicated, separately maintained pediatric guidelines. What is included in eviCores Comprehensive Oncology program? What types of cardiovascular procedures require prior authorization? Certain employer groups may require prior authorization or pre-notification through other vendors. Telephone:For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number, which can be found here. endstream endobj startxref Fax the request form to 888.647.6152. Or you can call Provider Services at . wont be able to apply to eviCore openings. For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. Subject: Sign- up for eviCore Healthcare's Training for new Prior Authorization requirements! eviCore made it easy to complete my primary task online. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Thank you for submitting information. eviCore healthcare (eviCore) Obtain benefit preauthorization for certain care categories. Receive support for technical or web portal related issue. Helpful Resources: Authorization Grids Services billed with the following revenue codes always require prior authorization: 0240-0249 All-inclusive ancillary psychiatric. Member Rights Policy | As a valued user of our website, wed appreciate your feedback to help us improve your website experience. By presenting lower-cost, convenient, and high-quality options, SmartChoice empowers members to make more informed comparisons and choices. 571 0 obj <>stream Our network of quality providers offers an attractive option for health plansseeking to more appropriately manage radiology benefits. As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, MEDICAL POLICIES endobj Contact us | Providers | Independence Blue Cross (IBX) we will be implementing changes to evicore.com in the near future. Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Check Status of Existing Prior Authorization. Copyright 2022 eviCore healthcare. Hospital and Outpatient Services. For Prior Authorization requests, use one of the following: CoverMyMeds: Website: CoverMyMeds.com (Preferred) Call: 1 (877) 813-5595 Authorizations/Precertifications | GEHA Verify Member's ID Card At each visit, the oce should ask to see the member's ID card to verify eligibility and to collect the appropriate copayment. What additional tools are available as add-on programs to the Cardiovascular solution? Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. Beginning Friday, December 18th at 5:00pm EST, you Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status of authorization request (s). Highmark has partnered witheviCorehealthcare (eviCore) for the following programs: Highmarkcontracts withWholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC.,forphysical medicine services- and naviHealth for Post-Acute Care for Medicare Advantage members. Prior Authorizations | AmeriHealth Caritas North Carolina | Providers If urgent (after-hours) call 866-322-6287 , from 9 p.m. to 9 a.m., Monday through Friday. Regardless of any Prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. <> Pre-authorization - Regence Participating providers can find more precertification phone numbers in Participating provider precertification list for Aetna (PDF). Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments. Website: eviCore.com Phone: 888.693.3297 (7:00 am-7:00 pm local time) Fax: 888.693.3210 Important notes You can generally determine if a customer's plan requires precertification for these services by looking for "Outpatient Procedures" on the back of their Cigna ID card. Learn more about the field of radiation oncology and how evidence-based guidelines enhance patient-centered care from Dr. Nimi Tuamokumo, eviCore Senior Medical Director and Radiation Oncologist.

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