Ask eviCore: Answering Your Most Commonly Asked Questions About Prior Authorization

Hi, I’m Mark Tate, and my Provider Experience team is working hard every day to make your experience with eviCore easier, faster, and more collaborative. For this month’s edition of Ask eviCore, we sat down with our web support team and they shared the most commonly asked questions they’ve received from you—our provider partners—over the last couple of months.

I am Having Trouble Logging In: The Login Page Just Keeps Refreshing

You will need to make sure the pop-up blocker is turned off in your web browser, or you will be unable to log-in to the site. 

I am Trying to Call in About a Prior Auth Request, but the Phone Volume is Too High, and My Call Isn’t Being Answered, or the Phones are Not Working. How Can I Submit My Prior Authorization Request?

Did you know that submitting a prior authorization request online for web authorization takes an average of 3 minutes, compared to a phone request, which takes an average of 12 minutes? Using the eviCore web portal is the most efficient way to initiate requests for prior authorization and to check the status of an existing request.  

Our self-service web portal is available 24/7, enabling you to initiate and review authorization information at your convenience. The portal login can be found on the homepage at www.evicore.com or on the Provider’s Hub page at https://www.evicore.com/provider.

· If you are a new user and need to create an account, visit: https://myevicoreportal.medsolutions.com/User/Registration/Index

· Brief video tutorials to help you register on the portal can be found on the Provider’s Hub at: https://www.evicore.com/provider. Select the “Training Resources” tab in the center.

Why am I Being Asked to Upload Clinical Data at the Beginning of the Prior Authorization Process?

We are continuously improving our prior authorization process to make it more efficient. We are replacing the provider clinical surveys with advanced technologies for advanced imaging cases. If your case does not receive a real-time approval, you may be asked to upload clinical documentation at the beginning of the case. By doing so, you will help reduce the amount of outreach the eviCore team has to send back to your office staff. Once you upload clinical data to the system, it will go directly to the clinical team for review.

And our data analysis shows the improvements are working! We’ve seen a 25% reduction in talk times for providers and a 50% reduction in our outreaches to provider offices for additional clinical documentation. Overall, providers are saving 2-4 minutes per each case in clinical submission time. The rate of cases being sent to clinical review is consistent with the legacy workflow involving clinical surveys.

I’m Not Receiving Information About My Prior Authorization Cases from eviCore Via Fax. How Can I Make Sure the Faxes are Being Sent to the Correct Number?

When initiating a request on the portal, the requestor’s phone and fax number will auto-populate; however, the listed information may not be the best contact for the individual submitting the request. It’s important to verify the contact information to ensure you expeditiously receive any phone or fax correspondences from eviCore to the number of your choice. There is no need to wait for a fax determination letter, you can check the status on the portal after logging in.

Which Platform Should I Use For This Prior Auth Case – MedSolutions or CareCore?

If you scroll down on the Provider’s Hub page, select the “Training Resources” tab in the center. Scroll down to the bottom of the Training Resources page, and you’ll see an option called, “I want to learn how to …”.

From the drop-down menu, select: “Start a New Prior Authorization.” You will need to select the health plan and the solution and then choose “Start,” and you will be directed to the platform you should use to submit a prior authorization request for your patient.

Am I able to toggle between MedSolutions and CareCore?

For example, if I am managing a case in the MedSolutions platform, how can I move to a case in CareCore?

At the far right of the menu bar at the top of each platform, you can select and transition to the other platform. A toggle feature at the top of the screen allows you to access both portals after logging in. This option is only available when moving between MedSolutions and CareCore.

How do I sign-up for training?

eviCore Provider Orientation Sessions are free, last approximately one hour, and are usually offered on Tuesdays and Thursdays each week. All sessions are scheduled in Central Time. Please register in advance. Whether you’re new to the web portal, or are an experienced user with questions, these sessions can help you maximize your web portal experience.

You can view the upcoming schedule and register for a webinar session here through the following steps:

·      Click on the menu on the far left-hand side, just below the eviCore logo, then choose “Webex Training.”

·      On the “Live Sessions” screen click the “Upcoming” tab. In the search box above the tabs, type this exactly as written: eviCore Portal Training.

·      Choose the date and time for the session you would like to attend and click the “Register” link beside that session. You will need to register separately for each session.

·      Complete the required information and click the “Register” button.

·      Immediately after registering, you will receive an email containing the toll-free phone number, meeting number, conference password, and a link to the web portion of the conference. Please keep the registration email so you will have the web-conference information for the session in which you will be participating.

I'm Using the eviCore Platform, and I Need Support. Who Can I Contact?

At this time, only a select group of clients and programs are using the eviCore Platform (often called EP360), as it is still in the pilot phase. In time, more clients and programs will transition to this platform, which is being designed in alignment with our user experience principles of intelligence, efficiency, consistency, clarity, and delight. Our goal is to create a more efficient and enjoyable experience for all of our users! Watch your inbox for future updates! If you have questions, please contact Web Support by phone at 800-646-0418 (Option 2) or via email at  portal.support@evicore.com.

If You’d Like to Learn More Tips About How to Successfully Navigate the Prior Authorization Process, Following are a Few Additional Resources:

·      Here’s a Checklist on how to Speed up Prior Auth

·      We also have a support page on our website that has the answers to many questions that you may have. Beyond the FAQs, the support page also includes some popular guides—including “How to Avoid Peer-to-Peer Phone Calls”—and other helpful resources.

I Need Help! How Can I Find Support?

·      Client Provider Support is available to assist with provider and health plan representative questions. Connect with Client Provider Support by e-mail atclientservices@evicore.com

·      For questions on the web portal, please contact Web Support by phone at 800-646-0418 (Option 2) or via email at portal.support@evicore.com

·      Add this address to your bookmarks so you can always reach us! https://www.evicore.com/provider/contact-support

If you have a question or a topic suggestion for a future edition of the Ask eviCore column, or you’d like to share your feedback about our prior authorization process or this newsletter, email Jackie Jenkins, the National Provider Advocate on my team, at providernewsletter@evicore.com By working together, we can ensure your patients get the best possible care. Thanks for reading this edition of Ask eviCore! 

Mark Tate

Master of Physical Therapy

Vice President, eviCore Provider Experience