Effective April 15, 2016, CareCore National, LLC d/b/a
eviCore healthcare (eviCore) will offer precertification approvals for
non-emergent outpatient radiation therapy services through an email
notification. These notifications will only be available for those requests
submitted through eviCore?s provider portal. Precertification requests
retrieved over the phone will continue to receive fax notifications.
This new functionality will only apply to authorized contacts who have
registered with a valid email address on the eviCore provider portal. The email
notifications are fully compliant with the Health Insurance Portability and
Accountability Act (HIPAA), and no Protected Health Information will be shared
in the email. The notification is only to confirm that a specific case has been
approved and will include instructions on how to log in to the provider portal
to obtain the details. Denials will continue to be faxed to providers, though,
and patients will continue to receive a letter to advise them of an approval or
denial.
Sample email notification
Below is a sample of the content included in the email notification:
- From: eviCore healthcare Notices (no replies to this
address please)
- Sent: April 15, 2016 2:36 PM
- To: (Provider Contact Name)
- Subject: eviCore healthcare E-Notification: Case
#123456789 has been Approved
There has been an update issued for Case #123456789. This
case has been approved and the Authorization number is
A123456789. To retrieve this information please click on the link
provided below to log in to the Web Portal and search by case or authorization
number. As part of our initiative to speed up communications and eliminate
waste, there will not be a separate fax sent to you for this approval unless
you request it.
Requesting precertification
You can initiate precertification for non-emergent outpatient radiation
therapy in one of the following ways:
- NaviNet® web portal. Select eviCore/CareCore
from the Authorizations option in the AmeriHealth Workflows menu.
- Telephone. Call eviCore directly at 1-866-686-2649.
NaviNet is a registered trademark of NaviNet, Inc.