Clinical-1

Clinical Guidelines

Cardiology & Radiology

Instructions for accessing the guidelines:

1. Search by health plan name to view clinical guidelines. If you would like to view all eviCore core guidelines, please type in "eviCore healthcare" as your health plan.

2. Locate the reason for denial section found in your letter. Identify the guideline title and then search by the guideline title.
Example for Neck Imaging Guidelines: Based on eviCore Neck Imaging Guidelines Section: NECK 9.1 Imaging, we cannot approve this request.

3. Scroll down to the table of contents page and select the appropriate guideline section from the denial reason.
Example for Neck 9: Based on eviCore Neck Imaging Guidelines Section: Neck 9.1 Imaging, we cannot approve this request.

Adult

Pediatric

Cardiology

Radiology