800.918.8924, For media inquiries please contactmedia@evicore.com. E-Verify and IER Right to Work. To check on the status of an authorization, please visit our provider secure web portal. Prior authorization status can be viewed on demand via the eviCore portal at www.evicore.com or by calling eviCore at 866-220-3071. Thank you for using eviCores website today! Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. What types of cardiovascular procedures require prior authorization? Should I reschedule? BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. stream Please click here to register for an account. How do I know when my test has been authorized? In addition, peer-reviewed literature, major treatises, input from health plans, and practicing academic and community-based physicians are also utilized in the construction of our guidelines. First, our innovative SmartChoiceprogram serves as a patient-outreach service to educate health plan members on available options for their diagnostic imaging procedure locations. reCAPTCHA is not valid; Please try again! Use theAvailityProvider Portalor your preferred vendor to check eligibility and benefits before rendering services. eviCore positions. <>>>/BBox[ 0 0 576 201.59] /Matrix[ 0.125 0 0 0.35716 0 0] /Filter/FlateDecode/Length 7100>> We already use the eviCore portal. Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. How did you get my phone number/information? 2 0 obj Prior authorization of a service is not a guarantee of payment of benefits. Benefits can vary; always confirm member coverage. Annual Utilization Statistics | eviCore currently maintains a nationwide advanced imaging network, featuring contracts with providers of imaging services in specific/predetermined locationsand as well as freestanding facilities. Were still hiring for other Report Fraud & Abuse | Simply, notify HAP within 48 hours of the emergency admission. Outpatient: 1-844-442-8012. Online forms from eviCore's carriers hub MENU PROVIDERS About; Solutions. *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * information about accessing the eviCore portal. Fax 866-873-8279. What types of radiology procedures require prior authorization? Services requiring prior authorization through eviCore are outlined below. Tune into our new Auth the Cuff episode with eviCore's Dianne Doherty, Sr. IMPORTANT: In the coming days, we will be migrating systems for our The Member Customer Care Center is open Monday-Friday, 8 am to 6 pm (ET). of authorization request(s). Refer to the Procedures that require authorization by eviCore healthcaredocument for more details. Please click here to register for an account. Report Fraud & Abuse | Why is eviCore providing intelliPath ePA free of charge for eviCore-managed lives? Report concerns to the BCBSIL Special Investigations Department (SID) Fraud website 1 . Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Digital Breast Tomosynthesis is a Hot Topic, Global Shortage of Iodinated Contrast Media, Q&A: eviCores Chief of Radiology on the Need for Evidence-Based Imaging, The 8 Most Common Inappropriately Ordered Tests and Why They're Being Denied, Check Status of Existing Prior Authorization. As a result, eviCore helps reduce inappropriate utilization, unnecessary radiation exposure, and invasive procedures and thereby improves patient safety. eviCores new electronic prior authorization eviCore intelliPath is already being deployed inside the existing prior authorization workflow and by provider organizations to automate and simplify the process of submitting and tracking requests for prior authorization. eviCore fax number: (800) 540-2406 Web Portal Services-Assistance 4 Web Support Phone: 800-646-0418 (Option 2) Email: portal.support@evicore.com Web Portal Services-Available 24/7 Pre-Certification Call Center Web-Based Services Client Provider Operations Documents Client Provider Operations Pre-Certification Call Center In some instances repeat exams for condition treatment or management will require prior authorization. eviCore.com. Were on a quest to improve the experience of administrators, clinicians, and patients who work with us. reCAPTCHA is not valid; Please try again! I need to change the date on my request. Call 1-800-TALK-MVP (1-800-825-5687) to speak with an MVP representative. What claims are subject to claims review? How does eviCore handle large gene panels? Review claim status and request claim adjustments. To determine which services require prior authorization (for medical necessity)** througheviCorefor BCBSTX government members, refer to: Medicaid providers eviCore.com 1-855-252-1117. How does a provider check the prior authorization status for a member? Please click here to register for an account. Service preapproval is based on the members benefit plan/eligibility at the time the service is reviewed/approved. List. If you need preauthorization, contact eviCore in one of three ways: Get immediate approval by submitting your request at www.evicore.com. What can physical therapy do for my lower back pain? Thank you for using eviCores website today! Intake form. Or . 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. Continue to Authorization Lookup Login Log In Forgot User ID? 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. In addition, they face growing administrative burdens. Benefits > CHS Group Information" or call the prior authorization phone number on back of the member's ID card. Copyright 2022 eviCore healthcare. Once a prior authorization request is received and processed, the decision is communicated to the provider. How will my doctor know where I am going? If you have questions, call eviCore healthcare at . *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * Simply visit the eviCores Providers Hub page and select the health plan and solution option for your case in the training section. What digital resources can I access to find out more information? Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Check Status of Existing Prior Authorization. One option is Adobe Reader which has a built-in reader. Hospital and Outpatient Services. . Listen to our latest podcast episode with new host, Dr. Emily Coe featuring Dr. Mayank Shah. Second, when requests reach a final status, the patient receives a letter indicating whether the request has been approved or denied. Check status of submitted authorizations. Certain employer groups may require prior authorization or pre-notification through other vendors. eviCore healthcare (eviCore) Obtain benefit preauthorization for certain care categories. Or you can call Provider Services at . E-Verify and IER Right to Work. 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. 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. Authorizations for HDHP, Standard and High Option members . Tune into our new podcast episode with eviCore's medical oncologists Dr. McLead, Associate Medical Director, and Dr. Gaskins, Sr. Medical Director, for an informative conversation on clinical trials, disparities in medical oncology, and how eviCore is aiming to bridge the gap with the most recent evidence-based options for oncology patients. Telehealth, Telemedicine Hologram Care? open positions so continue your job search at Cigna.com/careers. eviCore healthcare (eviCore) is an independent company that has contracted with BCBSIL to provide prior authorization for expanded outpatient and specialty utilization management for members with coverage through BCBSIL. All Rights Reserved. Phone Number 1.800.646.0418 x20136 Email portal.support@evicore.com Affiliations Stay Updated With Our Provider Newsletter Your email address Website Feedback Thank you for using eviCore's website today! of authorization request(s). we will be implementing changes to evicore.com in the near future. eviCore interacts with radiology patients in two ways. All Rights Reserved. we will be implementing changes to evicore.com in the near future. What if the request does not meet clinical criteria? Please retain the confirmation email. Q4: How can eviCore make it easier for you to use this website? All Rights Reserved. %%EOF What is included in the Radiation Oncology program? You might find that the answer is simpler than you think! Description. Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Call Utilization Management at 855-339-8127, 9 a.m to 9 pm., Monday through Friday. 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, For more information about prior authorization, please review Mercy Care's Provider Manuals located under the Provider Information tab on our website. Prior authorization lookup tool. wont be able to apply to eviCore openings. If you have questions on a request handled by BCBSIL, contact our Medical Management department. Copyright 2022 eviCore healthcare. If you do not remember your password, please click "Retrieve Password" below. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Prior authorization is required by eviCore healthcare for services performed for adult E-Verify and IER Right to Work. Member Rights Policy | Register Now Our newly redesigned provider solutions help reduce the complexities and costs involved in securing prior authorization(PA) for medical procedures and tests. 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. You can verify benefits and request prior authorization at Availity.com or by phone at 1-888-693-3211 1-888-693-3211. eviCore made it easy to complete my primary task online. This is not an all-inclusive list. endstream endobj startxref Receive support for technical or web portal related issue. Fax (24-hour) at 866-809-1370 . Availity provides administrative services to BCBSIL. 1-800-972-8382. What additional tools are available as add-on programs to the Radiology solution? Prior Authorization Automation. 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. By presenting lower-cost, convenient, and high-quality options, SmartChoice empowers members to make more informed comparisons and choices. of authorization request(s). Based on the feedback we receive, we continuously upgrade our operational efficiencies through ongoing addition of Web enhancements that improve the user experience and offeradditional support to our providers. Q1: Overall, how satisfied are you with eviCores website? Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the members policy certificate and/or benefits booklet and or summary plan description. Member Rights Policy | Most PDF readers are a free download. wont be able to apply to eviCore openings. The procedure codes contained in the lists below usually require authorization (based on the members benefit plan/eligibility). Subject: Sign- up for eviCore Healthcare's Training for new Prior Authorization requirements! BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. All Rights Reserved. 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. 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.

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