Announcements

Chiropractic and PT/OT Musculoskeletal Clinical Worksheets

August 10, 2017

Providers should be using our Chiropractic Clinical Worksheet and PT/OT Musculoskeletal Clinical Worksheet to make sure you and your staff have all the information you need to submit preauthorizations online.

These forms are only available through eviCore’s resources page for Health Alliance, which you can connect to from the Forms & Resources page. Similar forms available for general users on eviCore will not match up correctly with our preauthorizations, so please be sure to use our versions.

If you have any questions, contact your provider relations specialist.

More eviCore Preauthorization Online Training Sessions

June 27, 2017

Starting in August, eviCore will begin managing additional preauthorization services for our commercial and Medicare members.

For dates of service on or after August 1, you must request preauthorizations through eviCore on Your Health Alliance for providers. You can start using eviCore to submit these requests on July 14.

These additional, hour-long training sessions will go over how to submit preauthorization requests to eviCore and how to access tools and resources, including a quick reference guide.

Medical Oncology

Anyone who is responsible for submitting Medical Oncology preauthorization requests for our members should register for one of these online training sessions:

Preauthorization: Health Alliance Medical Plans – Medical Oncology

  • Tuesday, July 11 at 3 p.m. CST
  • Thursday, July 20 at 11 a.m. CST
  • Wednesday, July 26 at 9 a.m. CST

Radiation Therapy

Anyone who is responsible for submitting
Radiation Therapy preauthorization requests for our members should register for one of these online training sessions:

Preauthorization: Health Alliance Medical Plans – Radiation Therapy

  • Wednesday, July 12 at 9 a.m. CST
  • Monday, July 17 at 1 p.m. CST

Musculoskeletal Services: Pain/Joint/Spine and MSK Therapies

Anyone who is responsible for submitting Pain/Joint/Spine and/or PT/OT/ST preauthorization requests for our members should register for one of these online training sessions:

Preauthorization: Health Alliance Medical Plans – Musculoskeletal Services

  • Thursday, July 13 at 11 a.m. CST
  • Tuesday, July 18 at 10 a.m. CST
  • Friday, July 28 at 3 p.m. CST

Sleep Management

Anyone who is responsible for submitting Sleep Management preauthorization requests for our members should register for one of these online training sessions:

Preauthorization: Health Alliance Medical Plans – Sleep Management

  • Monday, July 10 at 2 p.m. CST – DME Providers Only
  • Friday, July 14 at 10 a.m. CST
  • Wednesday, July 19 at 11 a.m. CST
  • Friday, July 21 at 9 a.m. CST – DME Providers Only
  • Thursday, July 27 at 1 p.m. CST

How to Register

  • Once you’ve picked a session, go to eviCore.webex.com.
  • Choose the Training Center tab from the top menu.
  • Find the date and time of the session you want to attend in the Upcoming tab. All of the training sessions are named according to their specialty area, which are in the above sections before the training times.
  • Choose Register.
  • Enter your registration information.

Attending Your Online Training Session

After you’ve registered, you’ll get an email that includes:

  • The toll-free phone number and pass code you’ll need for the session’s audio
  • A link to the online session
  • The session password

Save this registration email to access your session, and don’t forget to mark your calendar and ensure you’ll be able to fully participate in the session.

You can also access the presentation materials by using the eviCore Resources link in the Forms & Resources section of Your Health Alliance for providers. Or you can get a copy of the presentation slides by emailing ProviderRelations@evicore.com.

The Assessment for Arterial Circulation

June 23, 2017

The assessment for arterial circulation starts with physical exam. If the symptoms suggest claudication, an arterial Doppler would be auto-approved. The treatment for claudication is medical, including a physician prescribed or vascular rehabilitation process, control of BP, medication consideration, nicotine cessation, lipid therapy, etc. Adequate time of therapy is needed before additional testing would be approved.

Limb threatening or vascular ulcerations are not indications for arterial Doppler and should have referral to vascular specialist for appropriate vascular contrast imaging.

Learn more in our assessment for arterial circulation graphic.

Email vs. Fax Notifications on eviCore

June 20, 2017

Online Requests

When you start a preauthorization through eviCore online through the Request Preauthorization tab:

  • If a valid email is entered, an email approval notification will be sent instead of a fax. Note: eviCore will not alert you that you’ve opted out of a faxed approval.
  • If you leave the email field blank, an approval notification will be faxed to you instead of an email notification.
  • No PHI will ever be shared in email notifications. Email notifications are case-specific and will include instructions to log in to eviCore for more details.
  • If eviCore can’t deliver the email to you, e.g. issues like your email inbox being full, the notification will then be faxed to you.
  • All requests from eviCore for additional clinical information will be faxed, not sent via email.
  • Denial notifications will be faxed

Delivery Methods

Emailed Notifications:

  • Status changes
  • Approval notifications

Faxed Notifications:

  • Requests for additional clinical information
  • Denial notifications
  • If email fails, status changes and approval notifications will be faxed

Phone and Fax Requests

When you start a preauthorization through eviCore over the phone or fax:

  • Approval notifications will be faxed to you.
  • All requests from eviCore for additional clinical information will be faxed, not sent via email.
  • Denial notifications will be faxed.

Delivery Method

Faxed Notifications:

  • Requests for additional clinical information
  • Status changes
  • Approval notifications
  • Denial notifications

Email vs. Fax Notifications on eviCore

June 9, 2017

If you enter a valid email address on eviCore, it will opt you out of receiving faxed notifications for that case automatically. You will have to check your email for those notifications.

If you must receive fax notifications for a case, do not enter your email address.