Jan 06th 2021

Top 10 Blog Posts of 2020

As we move into 2021, we wanted to take a moment to review some of the knowledge that we shared over the past year. We addressed some of the complexities of cancer diagnosis, artificial intelligence in healthcare, and support during COVID-19. We also shared some tips and insights on navigating prior authorizations, reducing costs for unexpected medical needs, and more.

 

In case you missed any of these helpful resources, here are our top 10 most popular posts from 2020.

 

Ask eviCore: Navigating Therapy Prior Authorizations

This edition of Ask eviCore discussed enhancements that were recently made to the prior authorization process for Physical Therapy (PT) and Occupational Therapy (OT). We also included some common reasons why therapy services may not be approved or approved only for a reduced number of visits. Our goal is to help our provider partners understand the process so we can better work together to ensure your patients get the medically appropriate care they need.

 

Ask eviCore: Portal Support

The topic of this Ask eviCore is the eviCore web portal. Using the eviCore web portal is the most efficient way to initiate requests for prior authorization and 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. We answered some of the most commonly asked questions that our portal-support team receives.

 

Ask eviCore: Workflow Updates

This edition of Ask eviCore answered a few questions we’ve been receiving lately and focuses on how eviCore is using technology to improve the prior authorization process and get to yes faster! 

 

Ask eviCore: COVID-19 Support

In this edition of Ask eviCore, we wanted to answer some of your questions about how we’re adapting to support providers and patients during the COVID-19 pandemic. As you all know, this is a fluid situation. We’re working closely with our clients to put the right solutions in place based on geographic location and member demographics, so please keep in mind that policies or protocols could vary among the respective states and health plans.

 

How Artificial Intelligence Can Make Hospital Administration More Efficient

The role of artificial intelligence (AI) is moving from a novelty to a necessity in the healthcare arsenal. Many healthcare organizations see the value of AI for a variety of applications, from support of better clinical decision-making, to improving operational efficiencies, to extracting key meaning and insights buried in big data files.

 

The Power of a Peer-to-Peer: Identifying an Unrecognized Clinical Condition

Sometimes a request for care—no matter how well-intentioned—is denied during the prior authorization process. When this happens, providers can learn more about the decision, and in certain circumstances have it reevaluated, by speaking with an eviCore clinician. While these peer-to-peer consultations often initially focus on gaps in the supporting documentation, they also generate discussion that can help improve a patient's care. In one recent instance, a consultation led to a new, more urgent diagnosis—and immediate approval for emergency surgery. 

 

Utilization Management Vendor for Durable Medical Equipment

With the wide-ranging clinical expertise available here at eviCore, I reached out to Dr. Erica David-Park, a board-certified specialist in physical medicine and rehabilitation with 15 years of direct clinical experience. She is currently eviCore’s Senior Medical Director for Post-Acute Care and Durable Medical Equipment. I asked Dr. David-Park the four questions I’m hearing the most. I found her answers to be informative and worth sharing with you.

 

Top 3 Most Common Types of Cancer for Men and Women in the United States

Cancer takes many forms, and some types of cancer are more likely to affect patients due to gender and other environmental factors. We compiled the most common cancer types for men and women as well as some lifestyle tips for prevention.

Patient Perspective: Delivering My Cancer Diagnosis

Delivering a cancer diagnosis is never an easy job for providers. It's nuanced. It's complicated. And even when there's hope for treatment or recovery, it's still a cancer diagnosis—something no one wants to hear. On the other side of the table, it's an entirely different experience. We spoke to patients who were on the receiving end of a cancer diagnosis and here's the feedback they wanted providers to know about their experience.

 

Reducing costs for Unexpected Medical Needs in an HDHP

At eviCore, we help patients in their search for top-quality and cost-effective care with our SmartChoice program. The program was established to provide patients with the clinical-quality and price-transparency information they need to make more informed healthcare decisions. Your plan may also offer other tools to help you navigate through healthcare costs.