The procedure codes contained in the lists below usually require authorization (based on the members benefit plan/eligibility). Fax an eviCore healthcare request form (available online) to 1-888-693-3210 Also, to ease the administrative burden of requiring prior authorization of OB Ultrasound studies, providers may batch service requests for up to 12 weeks and cases may be reviewed retrospectively for up to 3 business days following the date of service. 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. Introducing eviCores new podcast Auth the Cuff! View fee schedules, policies, and guidelines. Their sole job is to ensure patients get the best possible care. Most PDF readers are a free download. The Member Customer Care Center is open Monday-Friday, 8 am to 6 pm (ET). Some procedures may also receive instant approval. 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. wont be able to apply to eviCore openings. PNS contact tool. eviCores innovative SmartChoice program serves as a patient-outreach service that educateshealth plan members on available options for their advanced imaging procedure locations. CHCP - Resources - Sleep management - Cigna Effective May 1, 2023, AmeriHealth Caritas North Carolina (ACNC) will require prior authorization via eviCore healthcare for selected health care services. For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. Some authorization requirements vary by member contract.
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