What is eviCore used for?

What is eviCore used for?

eviCore is a medical benefits management company which helps patients avoid unnecessary care that can be expensive and potentially unsafe.

Is eviCore owned by Aetna?

eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for Aetna. Which members will eviCore healthcare manage for the outpatient diagnostic radiology and cardiology imaging services program?

Why did I get a letter from eviCore?

Navigating the letter you receive(d) from eviCore: If the request from your healthcare provider doesn’t meet the evidence-based guidelines, you’ll receive a letter from eviCore letting you know it wasn’t approved and why it was denied.

What is eviCore phone number?

Please contact us at (800) 918-8924 to change the date of your request.

Does Medicare use eviCore?

eviCore healthcare follows Medicare rules when applying coverage decisions for laboratory testing under Medicare Advantage plans. Medicare has devised a system where various contractors, called Medicare Administrative Contractors (MAC), set coverage policy for various jurisdictions, which cover specific states.

Is eviCore a Cigna?

Cigna works with eviCore healthcare (eviCore) to provide high-quality, cost-effective radiology services to Cigna customers in most markets for outpatient, nonemergency, high-tech radiology and diagnostic cardiology care. The following information outlines the highlights of the program.

What kind of company is eviCore?

eviCore healthcare
eviCore healthcare is a company that provides Utilization Management services for Health Plans or employer groups. eviCore healthcare’s mission is to provide Outpatient Diagnostic Imaging Service programs that improve quality and appropriateness of service.

How do I appeal my eviCore?

Peer-to-Peer Consultations can be requested online at https://www.evicore.com/pages/requestaconsultation.aspx. Detailed instructions can be found here. You are invited to continue to share your feedback, suggestions, and questions about our Prior Authorization process and this newsletter.

Did Cigna buy eviCore?

The announcement indicated that eviCore will become Cigna’s utilization management subcontractor assisting members with non-specialty infusions, and that eviCore will provide home health, all home infused medications, and durable medical equipment services for Cigna customers.

How do I contact eviCore?

You can also email us at [email protected], or reach us by phone at 800-646-0418, option 2.

Is eviCore owned by Cigna?

In its place, Cigna indicated that it would be using eviCore – a wholly-owned subsidiary of Express Scripts (and, in turn, Cigna) – as its new third party administrator for home infusion therapy services.

What is a Medicare LCA?

Local Coverage Articles (LCAs) Medicare contractors may issue LCAs, which are non-LCD documents that may. include specific coding instructions, clarify existing medical review policies, and/or. define ICD10 codes that support the medical policy. LCAs are posted, along with. LCDs, in the Medicare Coverage Database.2.

What kind of healthcare company is eviCore Healthcare?

In addition to the rebranding process, TA supported eviCore healthcare’s acquisition of Triad Healthcare, which enabled the company to expand into the musculoskeletal field. Today, eviCore healthcare is a national leader in integrated, innovative intelligent care management solutions for managed care and risk-bearing providers.

How to get in touch with eviCore support?

Email: [email protected] Phone: 1.800.918.8924

When does eviCore Healthcare close for the holidays?

eviCore healthcare is available from 7:00 a.m. to 7:00 p.m. Mountain time, Monday through Friday. eviCore is closed on New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and the Friday following, and Christmas Day.

What does eviCore do for prior authorization ( PA )?

This has been done to reduce outreach for additional clinical documentation. eviCore is continually working to enhance your prior authorization (PA) experience by streamlining and enhancing our overall PA process. You may notice incremental enhancements to our online interface and case-decision process.

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