Announcements

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.

Important Date Change for eviCore Preauthorizations

May 22, 2017

Your Health Alliance for providers will be ready to process eviCore preauthorization requests on July 14 for dates of service of August 1 and after for:

  • Musculoskeletal
  • Sleep
  • Medical Oncology
  • Radiation Therapy

Note: We originally shared that you could begin submitting preauthorizations for these programs on May 22 through eviCore, so please make note of the new date.

For dates of service through July 31, follow the current processes for preauthorizations for these programs. eviCore’s Genetic Testing module will be rolled out at a later date, and training will be available beforehand. Continue to submit genetic testing preauthorization requests as you do today.

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

More Training and Preauthorizations on eviCore

April 20, 2017

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

For dates of service on or after June 1, you must request preauthorizations through eviCore on Your Health Alliance for providers. You can start using eviCore to submit these requests on May 22.

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, April 25 at 11 a.m. CST
  • Thursday, April 27 at 1 p.m. CST
  • Wednesday, May 3 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, April 26 at 9 a.m. CST
  • Friday, April 28 at 1 p.m. CST
  • Thursday, May 4 at 10 a.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

  • Friday, April 21 at 1 p.m. CST
  • Monday, April 24 at 1 p.m. CST
  • Thursday, April 27 at 10 a.m. CST
  • Friday, May 5 at 9 a.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

  • Friday, April 21 at 9 a.m. CST – DME Providers Only
  • Monday, April 24 at 10 a.m. CST
  • Wednesday, April 26 at 2 p.m. CST – DME Providers Only
  • Tuesday, May 2 at 11 a.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.

Preauthorization Updates

March 28, 2017

We will be posting regular updates about functionality changes to our preauthorization tools—Clear Coverage, eviCore, and Health Alliance preauthorization forms.

eviCore

Finish Later and Attach Clinicals Later

  • This has been updated so provider offices can choose Finish Later to come back to an authorization within 2 business days. This also allows you to attach the clinicals before submitting a preauthorization.

OB Ultrasounds

  • At this time, multiple OB ultrasounds cannot be batched into one authorization request.
  • Submit separate authorizations when multiple exams are requested.
  • We’re working with eviCore for a solution, and we will keep you updated as changes occur.

Breast Ultrasounds

  • Do not require preauthorization.

OB/GYN Codes Flipped

  • From time to time, users experienced changes to CPT codes within the eviCore system. This issue has been corrected, and OB/GYN offices should no longer be seeing this problem.

Can’t Choose Rendering Provider

  • As of March 13, we’ve corrected the issue that you could not choose providers, including physicians, hospitals, and imaging centers, as the rendering provider or site. (You will no longer receive the message, “not certified for this program” when you made this selection.)

Rendering Provider vs. Ordering Provider

  • Rendering provider and ordering provider are the same as long as the rendering provider is not a hospital or imaging center.

Don’t Use the Enter Key on Your Keyboard

  • eviCore requires you to choose select, continue, or submit on a preauthorization. If you use the Enter key on your keyboard, the preauthorization will be lost, and it will take you back to the beginning.

Clear Coverage

Call with Inpatient Home Health Discharges Preauths

  • Preauthorizations for patients being discharged from an inpatient setting to home health will be handled by calling our medical management department. Use Clear Coverage for all outpatient home health preauthorizations.

Missing CPT Codes

  • The missing CPT codes for home health have been updated and can now be selected.