As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected,
we will be implementing changes to evicore.com in the near future.
Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status
of authorization request(s). Please click here to register for an account.
Resources
I Would Like To
Learn How To
Frequently Asked Questions
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Providers
- Getting Started
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Active Case
- How can I check my authorization status?
- What is an online clinical consultation?
- What do I do if a member’s eligibility is incorrect or not on file?
- I need to change the date on my request. What is the fastest way to do this?
- I need to change the CPT code on my request. What is the fastest way to do this?
- Denied Case
- Patients
- Health Plans
What claims are subject to claims review?
Technically, all claims for CPT codes that are in scope are subject to claims review. eviCore reviews the claim to make sure it received any necessary prior authorization. In addition, eviCore automatically applies over 44,000 lab-specific claim rules to ensure appropriate reimbursement for medically necessary tests. The vast majority of these rules apply to low-cost, high-volume tests that are not as amenable to prior authorization.