Submit authorization requests to eviCore healthcare prior to October 1 for procedures with dates of service on or after October 1
You can submit requests for authorization to eviCore healthcare (formerly CareCore National) prior to Oct. 1, 2015, for procedures with dates of service on or after October 1. EviCore can review these requests prior to October 1.
As a reminder, the table below shows the types of requests reviewed by eviCore.
| Dates of service | Types of requests | Pertinent procedure codes |
|---|---|---|
| Dates of service prior to Oct. 1, 2015 |
|
Outpatient high-tech radiology procedure code summary |
| Dates of service on or after Oct. 1, 2015 |
|
Procedures that require clinical review by eviCore healthcare |
These requirements apply to BCN HMOSM (commercial) and BCN AdvantageSM members.
Submit requests for authorization of these procedures in one of two ways:
- Preferred method: online at www.evicore.com
- By phone at 1-855-774-131
The requests must be reviewed prior to the services being rendered. If a treating physician does not receive a medical necessity determination and authorization number from eviCore prior to performing procedures for which eviCore's review is required, claims may not be reimbursed.