In general, there arethreestepsprovidersshould follow. 800.918.8924, For media inquiries please contactmedia@evicore.com. Dr. Torelli and Liz Avila are back today discussing the growing issue of rising healthcare costs. Terms of Use | As a valued user of our website, wed appreciate your feedback to help us improve your website experience. Please click here to register for an account. Member Rights Policy | Musculoskeletal (eviCore): 800-540-2406 Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number, which can be found here. Portal Login Insights Blog eviCore Colorectal Screening Program What is included in the Cardiovascular solution? You will be contacted by an eviCore representative within 5 business days. x]$9n7P&zK_0wv/"}Rla@hT_RIQD*;R{|Gvg|\~I%_)u. 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, $4d? vI While very useful when used appropriately, these studies have established some new guidelines to follow around this important test. Member Rights Policy | If you have any questions about this notice, please the Prior Authorization Department at (646) 473-7446. Thank you for using eviCores website today! Beginning Friday, December 18th at 5:00pm EST, you One option is Adobe Reader which has a built-in reader. eviCores innovative SmartChoice program serves as a patient-outreach service that educateshealth plan members on available options for their advanced imaging procedure locations. Eligibility Verification Providers should verify member eligibility prior to requesting/providing services. This new site may be offered by a vendor or an independent third party. 3 0 obj Continue to Authorization Lookup Login Log In Forgot User ID? endobj Report Fraud & Abuse | Specifically designed with the size and scale to address the complexity of our healthcare system today and tomorrow, eviCore is committed to advancing healthcare management through evidence-based medicine. In keeping with DFS guidance, MetroPlusHealth's UM protocols resumed on June 22, 2020, including resuming issuing Prior Approvals and performing concurrent review. First, our innovative SmartChoiceprogram serves as a patient-outreach service to educate health plan members on available options for their diagnostic imaging procedure locations. For precertification, go online to eviCore.com or use the contact information below. Please click here to register for an account. Q1: Overall, how satisfied are you with eviCores website? stream Call 1-800-TALK-MVP (1-800-825-5687) to speak with an MVP representative. IMPORTANT: In the coming days, we will be migrating systems for our 560 0 obj <>/Filter/FlateDecode/ID[<8C57985C8CBDD144A535DF79903CF9DC>]/Index[539 33]/Info 538 0 R/Length 105/Prev 288900/Root 540 0 R/Size 572/Type/XRef/W[1 3 1]>>stream Manager, Network Quality Assurance, Anne McLead, Sr. Director, Network Operations and Christa Gassler, Sr. Director, Affordability SoC, to learn how our site of care program advocates for clients and their covered members, how we identify high-quality freestanding imaging centers, negotiate costs for direct savings, and more. Thank you for using eviCores website today! Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Check Status of Existing Prior Authorization. wont be able to apply to eviCore openings. It speaks to the rapidly evolving healthcare industry, especially the increasing role of prior authorization and how providers can more effectively navigate it. eviCore healthcare - Horizon NJ Health Providers can call toll-free at 1-855-252-1117 between 6 a.m. to 6 p.m. (central time) Monday through Friday and 9 a.m. - noon Saturday, Sunday and legal holidays. Listen to our latest podcast episode with new host, Dr. Emily Coe featuring Dr. Mayank Shah. Listen to the new Auth the Cuff podcast for more information. eviCore healthcare (eviCore) Obtain benefit preauthorization for certain care categories. Please use the BCBSAZ MA prior authorization fax form or the eviCore online request tool, available on the secure MA . Please click here to register for an account. Q4: How can eviCore make it easier for you to use this website? Introducing eviCores new podcast Auth the Cuff! We offer providers ongoing touch-pointsthat include a team dedicated to on-site visits; professional surveys; and the rigorous tracking and receiving of feedback from both providers and our clients. Online forms from eviCore's carriers hub MENU PROVIDERS About; Solutions. Highmark requires authorization of certain services, procedures, and/or Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) prior to performing the procedure or service. How does a computer make healthcare decisions? Thank you for using eviCores website today! If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments. Helpful Resources: Authorization Grids What is the fastest way to do this? Where are Musculoskeletal Program guidelines and how are they accessed? Register Now Copyright 2022 eviCore healthcare. What digital resources can I access to find out more information? IMPORTANT: In the coming days, we will be migrating systems for our Moreover, eviCore is the only company in the industry with dedicated, separately maintained pediatric guidelines. Our newly redesigned provider solutions help reduce the complexities and costs involved in securing prior authorization(PA) for medical procedures and tests. 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. Prior authorization is a process that is often criticized for denying carebut is actually designed to protect patients by ensuring they get the right care. eviCore interacts with radiology patients in two ways. Were still hiring for other Q4: How can eviCore make it easier for you to use this website? Provider Support | eviCore As the chief medical officer of eviCore healthcare, a medical benefits management organization within Evernorth Health Services, Dr. Eric Gratias and his team work to ensure . *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * The terms of the members plan control the available benefits. endstream endobj 540 0 obj <. 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. With a PPO plan, you have the flexibility to seek care from doctors in and out of the network. eviCore positions. reCAPTCHA is not valid; Please try again! For quick reference, see the GEHA member's ID card. open positions so continue your job search at Cigna.com/careers, Were on a quest to improve the experience of administrators, clinicians, and patients who work with us. 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). wont be able to apply to eviCore openings. "eviCore has over 1,100 doctors, therapists and nurses from a variety of specialties. Medical Director -Cardiothoracic Surgeon -Remote - eviCore - Urgent With more than 25 years experience in utilization management, eviCore understands that maintaining a truly supportive provider experience requires more than supplying a few training sessions and establishing a phone line for questions. Services requiring prior authorization through eviCore are outlined below. eviCore.com 1-855-252-1117. How do I know when my test has been authorized? IMPORTANT: In the coming days, we will be migrating systems for our The list indicates which CPT codes require preauthorization based on site of service and diagnosis codes. Annual Utilization Statistics | All web users may now protect their portal accounts with an additional layer of security, including e-mail & SMS. View fee schedules, policies, and guidelines. endobj Learn more from eviCore experts Sid Govindan, MD and John Young on how eviCore is applying these technologies to evolve the prior authorization process. How does eviCore communicate with the patients provider? What is included in eviCores Comprehensive Oncology program? Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Medicaid Provider Information on COVID-19 Coverage, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms. \u003ca href=\"https://content.highmarkprc.com/Files/NewsletterNotices/SpecialBulletins/sb-post-phe-provider-communication.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"\u003e\u003cstrong\u003eCLICK HERE\u003c/strong\u003e \u003c/a\u003efor the details.\u003c/p\u003e","visible":false,"archive":false,"liveStatus":2}], Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (, Examples of services that may require authorization include, Potentially experimental, investigational, or cosmetic services, Select injectable drugs covered under the member's medical plan, Select Not Otherwise Classified (NOC) procedure codes, i.e., unlisted, miscellaneous, Not Otherwise Specified (NOS). For more detailed information, including specific CPT codes that requireeviCoreprior authorization, visit theeviCore implementation siteand select the BCBSTX health plan for the applicable CPT/HCPCS code lists and physician worksheets by service. As noted above, when you check eligibility and benefits, in addition to confirming if prior authorization is required, youll also be directed to the appropriate vendor, if applicable. Description. Services billed with the following revenue codes always require prior authorization: 0240-0249 All-inclusive ancillary psychiatric. If you have any questions, call the number on the member's ID card. For government programs prior authorization requests handled by eviCore healthcare (eviCore): Online - The eviCore Web Portal is available 24x7. -fUk23Hl\`U x@H2X"7"*,U D :|gx7e#FB|+9?{RX7:!m$wCrrra4Ok2gfMrTsw Medical Oncology: Call: 1 (866) 668-9250 Fax: 1 (800) 540-2406. we will be implementing changes to evicore.com in the near future. This is not an all-inclusive list. The online portal is designed to facilitate the processing ofauthorizationrequests in a timely, efficient manner. Q1: Overall, how satisfied are you with eviCores website? To determine which services require prior authorization (for medical necessity)** througheviCorefor BCBSTX government members, refer to: Medicaid providers Health Care Providers | BCBS of Tennessee 888-482-8057 Mon.-Fri., 8am - 11pm ET Sat., 8am - 3pm ET.