evicore prior authorization phone number

Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status $4d? vI Thank you for using eviCores website today! Q4: How can eviCore make it easier for you to use this website? endstream Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. 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. Provider costs are reduced and decisions are communicated in real time, reducing delays. Available Trainings eviCore periodically will host orientation sessions for providers for various care categories. Call 1-800-TALK-MVP (1-800-825-5687) to speak with an MVP representative. 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. eviCores innovative SmartChoice program serves as a patient-outreach service that educateshealth plan members on available options for their advanced imaging procedure locations. We would like to help. By presenting lower-cost, convenient, and high-quality options, SmartChoice empowers members to make more informed comparisons and choices. "eviCore has over 1,100 doctors, therapists and nurses from a variety of specialties. Intake form. 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, Or . . Simply visit the eviCores Providers Hub page and select the health plan and solution option for your case in the training section. Fax (24-hour) at 866-809-1370 . While very useful when used appropriately, these studies have established some new guidelines to follow around this important test. Watch or listen to the latest Auth the Cuff podcast episode with our host, Dr. Emily Coe, featuring Dr. Joseph Weiss, where we discuss all things gastroenterology. Utilization Management. Obtain prior authorizations through eviCore using one of the following methods: eviCoreperiodically will host orientation sessions for providers for various care categories. open positions so continue your job search at Cigna.com/careers, Something went wrong.Please try again after some time, Thank you for submitting. Credentialing Credentialing and joining our network - 1-800-353-1232 (TTY: 711) Special programs and other phone numbers Availity help - registration questions, help with user name/password - 1-800-282-4548 . For government programs prior authorization requests handled by eviCore healthcare (eviCore): Report Fraud & Abuse | What is included in the Radiation Oncology program? Dont I have to go to a hospital for my procedure? Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Check Status of Existing Prior Authorization. Q4: How can eviCore make it easier for you to use this website? Hospital and Outpatient Services. Certain employer groups may require prior authorization or pre-notification through other vendors. For commercialprior authorization requests handled by AIM Specialty Health(AIM): Commercial non-HMO prior authorization requests can be submitted to AIM intwo ways. 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. Authorizations for HDHP, Standard and High Option members *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * Bluffton, SC 29910 Availity is a trademark of Availity, LLC., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Please click here to register for an account. open positions so continue your job search at Cigna.com/careers. Fax 866-873-8279. Effective May 1, 2023, AmeriHealth Caritas North Carolina (ACNC) will require prior authorization via eviCore healthcare for selected health care services. The table will help you determine if you can use the approved prior authorization, modify the original or request a new one. 571 0 obj <>stream 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. Please be reminded, effective June 1, 2023, AmeriHealth Caritas Florida will require prior authorization from eviCore Healthcare for the covered health care services listed below: Please join us in reflecting back on the best moments from Auth the Cuff in 2020. IMPORTANT: In the coming days, we will be migrating systems for our Use your practice management system or vendor: Health Care Request and Response (ANSI 278) - Contact your Electronic Data Interchange (EDI) or Practice Management System vendor. The reality is, most providers weren't initially trained to deliver virtual care. Ethics & Compliance | Our host Emily Coe, PhD, speaks with Alegis Care social worker Katie Sherman, MSW, LCSW, to learn more about home health, social determinants of health, access to care, and more. Federal Employee Program (FEP ) Verify eligibility and benefits and/or check claim status for FEP members. Q4: How can eviCore make it easier for you to use this website? Additional information about the programs and links to prior authorization codes are available under Care Management Programs in the left website menu. 400 Buckwalter Place Blvd. Some authorization requirements vary by member contract. Additional information on authorizations can be found in Chapter 5 (Care & Quality Management) of the Highmark Provider Manual. Availity Essentials, Essentials Plus, or EDI Clearinghouse Customers: If you have an Availity Essentials, Essentials Plus, or EDI Clearinghouse account and cannot log in to submit a ticket, call 1-800-282-4548 for support. Online forms from eviCore's carriers hub MENU PROVIDERS About; Solutions. If you do not remember your password, please click "Retrieve Password" below. Refer to theeviCore Webexpage to register and the select the menu bar symbol located on the left-side of the webpage and select "Webex Training". Privacy Policy | The site may also contain non-Medicare related information. For additional resources on the Helion Arc authorization process, includinginstructionalvideos,CLICK HERE. eviCore positions. Tune into our new Auth the Cuff episode with eviCore's Dianne Doherty, Sr. 1-888-MDAETNA (1-888-632-3862) (TTY: 711) for all other plans. If you have questions on a request handled by AIM or eviCore, call the appropriate vendor, as noted above. If you are unable to use electronic prior authorization, you can call us at 1 (800) 882-4462 to submit a prior authorization request. Q1: Overall, how satisfied are you with eviCores website? Privacy Policy | PPO members You don't need to worry about referrals. Why didn't you call me the last time I had a procedure? Frequently asked questions about requesting authorization from eviCore healthcare The eviCore intelliPath. Positron emission tomography computed tomography (PET-CT), Computed tomography angiography (CTA) scans, Non-OB ultrasound including head & neck, pediatric, breast, abdomen & retroperitoneum, extremity, arterial & venous, and gynecological, OB ultrasound including obstetrical ultrasounds and fetal echocardiography, eviCore currently maintains a nationwide advanced imaging network, featuring contracts with providers of imaging services in specific/predetermined locations. CareCore National Web Portal Friday, April 28, 2023 10:41 AM For log in problems: Please try the email address that you registered with as your user name. Find Contact Information; Podcasts; GO TO PROVIDER'S HUB. You're being redirected to the CMS search site. Clinical Resourcespage on theBCBSTX Medicaidwebsite. Report Fraud & Abuse | Services requiring prior authorization through eviCore are outlined below. In order to determine the appropriate portal to use to submit your prior authorization, we have made it easy for you. ** Prior authorization determines whether the proposed service or treatment meets the definition of medical necessity under the applicable benefit plan. of authorization request(s). Q4: How can eviCore make it easier for you to use this website? The system can easily be made an extension of the clients existing claims workflow. its a guideline to help us practice medicine better, and to keep safety in mind for our patients by not over utilizing explains Dr. Robert Good, VP & Associate Chief Medical Officer for Carle Health, on how eviCores solutions have made a difference for their patients in the newest Auth the Cuff podcast. A prior authorization isnota guarantee of benefits or payment. Continue to Authorization Lookup Login Log In Forgot User ID? Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, CAR-T Cell Therapy & Medical Oncology Disparities, Crunching the Numbers! 539 0 obj <> endobj From cultural moments, to utilization management, capsule endoscopy technology advancements, and more. 0 So how do we continue to think about best practices for telehealth? In this weeks podcast, Dr. Torelli and Liz Avila discuss why its important for all patients to learn more about their care. we will be implementing changes to evicore.com in the near future. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. What types of services are managed under your sleep 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. reCAPTCHA is not valid; Please try again! Forgot Password? wont be able to apply to eviCore openings. please email the case number and request to: [email protected]. How does eviCore communicate with the patients provider? 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 If you have questions on a request handled by BCBSIL, contact our Medical Management department. We already use the eviCore portal. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Were still hiring for other Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. Thank you for submitting information. Should I reschedule? All Medicare authorization requests can be submitted using our general authorization form. All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. How do I obtain clinical certification for radiology tests? Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization. Beginning Friday, December 18th at 5:00pm EST, you All web users may now protect their portal accounts with an additional layer of security, including e-mail & SMS. Terms of Use | 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. The instructions on how to submit a case and a link to the correct portal to use will be provided. How do I know when my test has been authorized? eviCore.com 1-855-252-1117. Finally, eviCore manages select cardiology and radiology services for dates of service prior to Oct. 1, 2018, including postservice requests. To view this file, you may need to install a PDF reader program. Use theAvailityProvider Portalor your preferred vendor to check eligibility and benefits before rendering services. Hospitals should contact CareAllies at (800) 227-9360 to obtain prior authorization. Review claim status and request claim adjustments. I agree to HIPAA Disclosure Remember User ID LOGIN Don't have an account? Our newly redesigned provider solutions help reduce the complexities and costs involved in securing prior authorization(PA) for medical procedures and tests. endobj How does eviCore interact with providers? EmblemHealth Reduces Preauthoriz . Learn about the growing field, along with eviCore and Alegis Care's home solutions on our new Auth the Cuff podcast episode with Dr. Yvette LeFebvre, Chief of PAC/DME/Sleep Services. eviCore currently maintains a nationwide advanced imaging network, featuring contracts with providers of imaging services in specific/predetermined locationsand as well as freestanding facilities. What is the fastest way to do this? eviCore made it easy to complete my primary task online. 4 0 obj Please click here to register for an account. Our proprietary integrated system, Claims Studio, delivers savings through an enhanced focus on accurate claims payment. eviCores Radiology solution delivers cost savings and improved patient outcomes by ensuring health plan members receive the appropriate test or treatment necessary for their individual case presentation or condition. Prescription drug prior authorization 24 hours a day, 7 days a week: 1-888-678-7015 Fax: 1-888-671-5285: . You will receive a letter in the mail and your physician will receive a letter via fax communicating this information. View fee schedules, policies, and guidelines. Member Rights Policy | Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Or you can call Provider Services at . The associated preauthorization forms can be found here. of authorization request(s). Telehealth, Telemedicine Hologram Care? MCG Clinical Criteria- Information on Highmark's incorporation of MCG Health evidence-based clinical guidelines into Highmarks criteria of clinical decision support. What can chiropractic services do for my lower back pain? Highmark will provide written notice when codes are added to the list; deletions are announced via online publication. Why is eviCore providing intelliPath ePA free of charge for eviCore-managed lives? we will be implementing changes to evicore.com in the near future. If the requested exam is denied, eviCore will notify both you and your physician and provide you with detailed appeal instructions. Information for Blue Cross and Blue Shield of Illinois (BCBSIL) members is found onour member site. eviCore intelliPath streamlines operations within a single easy-to-use application that integrates with major EHRs. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Care Management Programs Providers and/or staff can request prior authorization and make revisions to existing cases by calling 1-866-496-6200. Create an Account. The list indicates which CPT codes require preauthorization based on site of service and diagnosis codes. I agree to HIPAA Disclosure Remember User ID LOGIN Don't have an account? Radiation Therapy: Call: 1 (866) 686-4452 . [{"id":39210,"versionId":6468,"title":"Highmark Post-PHE Changes","type":4,"subType":null,"childSubType":"","date":"4/7/2023","endDate":null,"additionalDate":null,"imageUrl":null,"url":null,"urlText":null,"description":"\u003cp\u003eWith the upcoming expiration of the PHE, Highmark has started the process of updating COVID-19-impacted policies and procedures. GHI Medicare non-City of New York. wont be able to apply to eviCore openings. The incredibly popular & eloquent nuclear stress test has been the subject of some recent studies on frequency. 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, Part of it involves making sure the computer speaks the same language as the medical records. Additional information on authorizations can be found in Chapter 5 (Care & Quality Management) of the Highmark Provider Manual. Tune into our new Auth the Cuff podcast episode with guest Dr. David-Park, Sr. Medical Director PAC/DME, for a great conversation on over utilization, a real-life patient example, and more. If urgent (after-hours) call 866-322-6287 , from 9 p.m. to 9 a.m., Monday through Friday. eviCore will communicate the determination utilizing the following methods: Thank you for using eviCores website today! Which EHRs does eviCores intelliPath ePA support? Member Rights Policy | Directory Who to Contact for Preauthorization All providers must verify member eligibility and benefits prior to rendering non-emergency services. How does a provider check the prior authorization status for a member? endobj What services are managed through the Musculoskeletal Surgical Program? The site may also contain non-Medicare related information. What additional tools are available as add-on programs to the Radiology solution? 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 . information about accessing the eviCore portal. Privacy Policy | The procedure codes contained in the lists below usually require authorization (based on the members benefit plan/eligibility). 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. There is a notion of utilization management being solely focused on cost savings. Register Now As a valued user of our website, wed appreciate your feedback to help us improve your website experience. Were on a quest to improve the experience of administrators, clinicians, and patients who work with us. List. endobj Our goal is to provide high-quality, cost-effective sleep management services to customers who are covered under benefit plans that include precertification of outpatient procedures. The associated preauthorization forms can be found, Gastric Surgery/Therapy/Durable Medical Equipment/Outpatient Procedures: 888-236-6321, Home Health/Home Infusion Therapy/Hospice: 888-567-5703, WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC.,for, View the List of Procedures/DME Requiring Authorization, View the List of FEP Standard and Basic Procedures/DME Requiring Prior Approval, View the List of FEP Blue Focus Procedures/DME Requiring Prior Approval, Non-Urgent Inpatient Authorization Submission, Urgent Inpatient Authorization Submission, Auth Automation Hub Frequently Asked Questions, Advanced Imaging and Cardiology Services Program, Musculoskeletal Surgery and Interventional Pain Management Services Prior Authorization Program, Post-Acute Care for Medicare Advantage members, Inpatient admissions (e.g., acute inpatient, skilled nursing facility, rehabilitation hospital, behavioral health facility, long-term acute care facility), Speech Therapy services, including those provided to Medicare Advantage members. Tune into our latest Auth the Cuff podcast episode featuring pediatric oncologists Dr. Michelle Neier and Dr. Jessica Roberson, along with pediatric radiologist Dr. Keith Kronemer, who speak with Dr. Emily Coe on the impact COVID-19 has had, and may continue to have, on pediatric care. of authorization request(s).
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