Who We Help
eviCore offers our providers real-time access to patient authorization and eligibility information via the Web. In addition, you can submit requests at any time that best suits your schedule.Stay informed. We offer convenient access to valuable resources such as current clinical guidelines and worksheets, comprehensive tutorials that overview specific registration and submission processes, and program tools and criteria. We also furnish our providers access to important contact information so that they can reach the appropriate department for immediate assistance.
Have questions? We have provider engagement representatives, who are dedicated to providing support for inquiries and specialized training. Email us at firstname.lastname@example.org and we will get back to you shortly.
eviCore healthcare Network Facility Standards (Radiology)
Accreditation requirements reviewed during onsite evaluation (*Not required for all health plans)Accreditation modules offered by recognized accreditation boardsRoutine appointment scheduling standards (*Not required for all health plans)
Accreditation requirements reviewed during onsite evaluation (*Not required for all health plans)
Accreditation modules offered by recognized accreditation boards
Routine appointment scheduling standards (*Not required for all health plans)
eviCore healthcare Physician Credentialing Standards
Please contact the eviCore credentialing team to request access to the AppCentral online credentialing application at email@example.com.
Imaging Facility and Radiologist Credentialing Application Tutorial
Contact the eviCore Quality Assessment team at firstname.lastname@example.org
eviCore strives to promote appropriate use of diagnostic imaging by the Health Plan's contracted primary care physicians, specialty physicians and other health care professionals in office settings. For your convenience, attached you will find fax forms for the submission of certificates/accreditations pertaining to the Self-Referral Payment Policy.
HIP Fax Cover Sheet for Accreditation
Horizon Fax Cover Sheet for Accreditation
Oxford Fax Cover Sheet for Accreditation
WellCare Fax Cover Sheet for Accreditation
eviCore participating providers may be subject to payment rules specific to Radiology. The payment rules are utilized to ensure the correct coding of radiology claims and to adjust reimbursement for multiple procedures rendered to the same patient in a single office visit. An eviCore participating provider username and password for access to the eviCore payment rules is required. If you do not have a username/password you may submit a request for one or contact your eviCore Provider Relations Representative for assistance. Additional detailed information is provided in the eviCore/HealthPlan specific Provider Manual.
Several of eviCore‘s Health Plan clients have adopted payment rules similar to those presented here, but each Health Plan may be unique in their application of these rules. To validate the Payment Rules being applied to Radiology claims for a Health Plan, please visit the Provider Resources area of that Health Plan‘s website for specific information.