What is included in EviCore by Evernorth Home Health?
The EviCore Home Health program provides skilled care services, such as nursing, physical therapy, occupational therapy, speech therapy and social work, in the comfort of the patient’s home.
The process begins with a referral from a licensed medical provider (such as a doctor, nurse practitioner or physician assistant) to a home health agency (HHA). The HHA will do the following:
- Receive the request for a medical necessity review, if required, from the patient’s insurance company.
- Send a skilled provider (e.g., a nurse or physical therapist) to the patient’s home to perform a thorough assessment.
- Develop a suggested plan of care, which is sent to the referring provider for review.
- Submit the assessment and care plan to clinical reviewers at the insurance company if additional visits are needed. These reviewers compare the information to evidence-based guidelines and collaborate with the home health provider to determine coverage.
This program ensures patients receive high-quality, coordinated care, tailored to their individual medical needs, at home.