UPDATED: Effective Aug. 18, in some instances, only eviCore's electronic system and letters will display the correct number of units authorized for cardiology, radiology and radiation therapy services for BCN members

For Blue Care Network providers submitting authorization requests to eviCore healthcare for the cardiology, radiology and radiation therapy services eviCore manages for BCN, a change will take place in mid-August.

Currently, both eviCore's electronic system and BCN's e-referral system show the same number of units authorized by eviCore.

Beginning Aug. 18, 2016, in some instances, you may see 250 units authorized in BCN's e-referral system for each service approved by eviCore. This will be more than the actual number of units authorized by eviCore. It is necessary for the 250 units to be downloaded to BCN's e-referral system to facilitate the payment of claims.

In these instances, the actual number of units authorized by eviCore will be visible in eviCore's electronic system and will be included in the letters eviCore sends.

So, starting Aug. 18, if the e-referral system shows 250 units authorized for your request, you should visit eviCore's electronic system and read the letters eviCore sends, to see the correct number of units authorized. When the e-referral system shows 250 units authorized, these will not be the correct number of units authorized.

As a reminder, eviCore healthcare reviews certain outpatient radiology, cardiology and radiation therapy services for BCN. Separately, eviCore also reviews physical, occupational, and speech therapy, and physical medicine services provided by chiropractors. Starting Sept. 1, eviCore will also review non-emergent pain management services for facet joint and epidural injections.

Additional information is available at ereferrals.bcbsm.com. Click BCN. Finally, click eviCore-Managed Procedures.

Posted: August 2016
Line of business: Blue Care Network