Enabling better outcomes.

  

Solutions: Connecting the dots between everyone

eviCore brings together the broadest range of integrated, innovative medical benefits management solutions across the entire healthcare continuum, enabling better outcomes for our patients, providers, and plans.

Specialty Solutions

  • Musculoskeletal

    Delivers a comprehensive suite of musculoskeletal solutions that focuses on a patient-centered approach.

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  • Radiology

    Decreases the use of unwarranted tests and exposure to unnecessary radiation.

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  • Radiation Therapy

    Optimizes patient outcomes by assessing a patient’s specific disease state, stage, and treatment goals.

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  • Cardiology

    Decreases the utilization of inappropriate cardiac imaging tests, diagnostic services, and implantable devices.

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  • Medical Oncology

    Utilizes disease-specific algorithms to optimize clinical and financial outcomes through clinically appropriate treatment.

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  • Sleep

    Lowers costs and improves patient outcomes by analyzing patient’s therapy use and basing interventions on the results​.

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  • Post-Acute Care

    Helps patients receive the right care in the right setting after a hospital stay to improve health outcomes and lower cost.

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  • Lab Management

    Ensures appropriate utilization of genetic testing through clinical policy, medical necessity review, & claims payment rules.

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  • Specialty Drug Management

    Employs evidence-based guidelines to ensure appropriate use, drives drug administration, and ensures payment integrity.

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Market Solutions

  • Provider

    Ensures providers meet their financial objective while acting as an extension of their model.

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  • Health Plan

    Bringing value to the health plan; utilizing evidence-based tools; & engaging providers to contain costs and improve health.

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  • Government

    Provides specialty solutions to the government marketplace.

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About eviCore: At the core of change

eviCore is a medical benefits management company—through its unique position at the heart of patients, providers, and plans information—is committed to making a positive impact on healthcare.

With more than one thousand doctors and nurses amongst our experienced professionals, we have the expertise to address the perspectives and needs of all our healthcare clients. This complements an evidence-based, patient-centric approach that allows us to integrate and apply more informed insights – prompting more focused actions, more custom solutions and services, and more improved results.

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Our Story

eviCore is driven by one simple goal: better outcomes.
  • 20+
    Years of Experience
  • 100M+
    Members Managed
  • 3,000+
    Employees Nationwide
  • >1,000
    Clinicians
  

Media: Now & Next

What’s happening at eviCore? Keep connected and informed of the latest developments, right here.

Merge Healthcare and eviCore healthcare Partner to Streamline Medical Imaging Pr...
Press Release

Partnership will expand Merge’s iConnect® Network Services to include nearly 100 million insured individuals currently served by eviCore’s payer clients.

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CareCore | MedSolutions Rebrands as eviCore healthcare
Press Release

Complementary capabilities make a medical benefits merger to benefit everyone.

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The 5th “R” of Personalized Medicine: Right Cost
Blog Post

A recent article published in Managed Care highlights the flood of new diagnostic forces and why insurers are starting to ramp up prior authorization and utilization review. Today’s torrent of information around genetic and molecular markers for disease has outstripped the ability of physicians, health plans, and patients to know exactly what every new test means. Sometimes clinical labs introduce up to 10 new genetic lab tests per week. This number means that many plans are deciding to adopt prior authorization for genetic tests.

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