Providers Delivering Medical
Solutions Tha​t Benefit Every​​one.

 
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Provider Promise

Provider Promise : Connecting The Dots

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 portal.support@evicore.com and we will get back to you shortly. 



Network Standards

Network Standards and Credentialing Applications

​​Accreditation requirements reviewed during onsite evaluation (*Not required for all health plans)

Routine appointment scheduling standards(*Not required for all health plans)

eviCore healthcare Physician Credentialing Standards

MSK Standards

Facility and Provider Applications​

Please contact the eviCore credentialing team to request access to the AppCentral online credentialing application at credentialing@evicore.com.

Imaging Facility and Radiologist Credentialing Application Tutorial

Questions?

Contact the eviCore Quality Assessment team at credentialing@evicore.com

Imaging Facility and Radiologist Credentialing Application Tutorial

Accreditation​​​

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

Appeals

Appeals

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.

Resources and Criteria
Claims Portal Login
Authorization Eligibility Lookup
Horizon BCBS NJ