Oct 14th 2019

Breaking Down Our Patient Promise

After receiving your recent diagnosis, you’ve attempted to do the research. You’ve sifted through pages and pages of healthcare information from your doctor and identified and visited numerous websites, trying to make some sense of what this could mean for your everyday life. The various descriptions may be different, but the information is all starting to sound the same. You decide to look up one more site: the company that will be managing your prior authorizations for care. You read: “eviCore empowers the improvement of care for patients by promoting appropriate, evidence-based decision making and quality measurement. We also help educate patients and providers as well as strengthen the patient-provider relationship.”

Obviously, there is more importance to those words than just their face value. They promise transparency, partnership, and a pathway to the most effective and appropriate care available. They evoke a deeper understanding of the nature of the healthcare system at large, and a partnership with a doctor with whom we will serve as an advocate for your health, wellness, and financial health.

 

Empowering the Improvement of Care

Historically, healthcare was perceived as something mysterious and even magical. The modern provider and patient know better: it predominantly rests on science! As such, we patients can sometimes find ourselves in the midst of trial-and-error, so it’s important that we stay up-to-speed with the plan of action for our care. When we see our doctor because of a medical issue, we are looking for relief or at the very least answers, and the more we communicate and collaborate as a health team, the better. eviCore sees you, the patient, as a decision-maker; we want to enable you to ask the right questions, truly engage in your healthcare decisions, and work with your doctor to navigate the best path back to wellness. Your participation can be a valuable tool when facing the fear and confusion that often comes with an unexpected diagnosis. Your provider is the expert, of course, so eviCore’s Medical Directors strive to work cooperatively and efficiently with him/her on the strategic choices for your care strategy. Today, patients are encouraged to understand and make informed decisions about their healthcare in our modern world.

 

Promoting Appropriate, Evidence-based Decision Making

The rate of information gathering and dissemination in our modern, technology-driven world is immense compared to even 20 years ago. In fact, as our very own Dr. Gratias has said: “It is projected that by the year 2020, cumulative medical knowledge will be doubling every 73 days.[1] At that rate, it can be argued that no professional anywhere in the healthcare system would be able to keep up.“ And as mankind continues to grow and learn about the world of health and wellness, that timeframe of growth will just get shorter and shorter. eviCore, by providing what amounts to “second opinions” in diagnostic and treatment decisions (and paying attention to what is/is not covered by a patient’s health plan), can help make sure that all new and relevant evidence-based information is considered when you’re beginning a course of treatment with your provider. Using our guidelines, we help provide another perspective on the emerging data and knowledge that our teams spend hours researching.

 

Ensuring Quality Measurement

There’s a saying in business, “You can have it fast, good, or right.” As a responsible consumer and patient you are probably thinking, “I definitely don’t want that saying to apply to my healthcare”. Fortunately, today you can retrieve quality ratings for a more complete picture of the healthcare facilities you might visit on your care journey. For example, when you purchase a plan that uses eviCore’s “SmartChoice” program, we make sure your test is appropriate (or, medically necessary) and that you’ll undergo that test in a convenient, high-quality, and cost-effective facility. “Good” and “right” should be givens when we’re talking about health, and “fast” is definitely a plus when time is a factor to successful treatment. Having someone as your advocate when tackling a health issue is always a plus.

 

Building a Patient & Provider Relationship

Now more than ever, there’s a lot of talk in the healthcare space about the doctor/patient relationship, but what does that really mean for us as patients? Here’s the real truth: it’s easier to trust someone if you know who they are and what they’re about. Establishing an environment of trust and cooperation with your provider is a great way to feel confident in the healthcare decisions you will make with them as you grow and age throughout your life. eviCore is at your side to work collaboratively with you and your provider as you develop such a relationship, and we can serve as another hand to hold when and if you need it.

So, there’s a short way and a long way to break down eviCore’s patient mission, but either approach should provide you a new perspective to take away as a patient: We will work with you and your provider to offer a second set of eyes from a clinical guardian perspective when it’s needed, and we will help make sure that you receive the most modern and successful (data-proven) care, in the right facilities, for your needs and health plan coverage.

You can rely on the commitment and expertise of the eviCore family, and their appreciation of the human side of healthcare. We encourage you to bookmark on your phone the patient resources page on the eviCore website and review the list of articles offering more information on prior authorization and the healthcare space.



[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116346/