Frequently Asked Questions

Why was my test, treatment, or procedures not approved?

These are some of the most common reasons that a test, treatment, or procedure might not be approved:

Need more clinical information: Sometimes EviCore needs more clinical information from your healthcare provider, like medical history or tests you’ve already had, to determine if the request meets the latest evidence-based medical guidelines.

More conservative therapy should be tried first: Evidence-based guidelines often point to trying conservative solutions like rest, ice, or elevation first before moving on to more invasive options that involve scans, scopes, and needles.

Lack of a precursor test: In some cases, the order of treatment requires that a precursor test – like an ultrasound or x-ray – should always be tried prior to a more complicated procedure like advanced imaging (such as an MRI or a CT scan) or surgery.

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