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Effective September 2, 2016, updated AmeriHealth Radiation
Therapy Clinical Guidelines will be used by CareCore National, LLC d/b/a
eviCore healthcare (eviCore).
AmeriHealth requires precertification/preapproval through eviCore to manage
requests for select outpatient, non-emergent radiation therapy services for
members enrolled in its commercial and Medicare Advantage plans. eviCore will
use the updated Radiation Therapy Clinical Guidelines to determine the
medical necessity for the delegated radiation therapy services. To access the
updated guidelines, go to eviCore's Radiology Tools and
Criteria page, and scroll down to "AmeriHealth."
Requesting precertification
You can initiate precertification for non-emergent outpatient radiation
therapy in one of the following ways:
- NaviNet® web portal. Select CareCore from the
Authorizations option in the AmeriHealth Workflows menu.
- Telephone. Call eviCore directly at 1-866-686-2649.
If you have any questions, please contact your Provider Partnership Associate
or Network Coordinator.
NaviNet is a registered trademark of NaviNet, Inc.
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