Health Alliance Medical Plans Implementation Resources

Health Alliance is pleased to announce that we will be expanding our partnership with EviCore by Evernorth to include prior authorization management for Commercial and Medicare networks for Vascular Intervention services for dates of service January 1, 2024 and beyond.

Additional information regarding current and upcoming programs can be accessed via the General Resources and Solution Resources tab above. More details to come.

Effective 8/1/22

Health Alliance Medical Plan (HAMP) will be discontinuing the Ultrasound (US) Program.

Prior Authorization will not be required through EviCore.

Please check with the health plan for any requirements they may have after 8/1/2022.

EviCore by Evernorth is pleased to announce its partnership with Health Alliance Medical Plans to provide preauthorization services. 

Health Alliance Medical Plans has expanded its partnership with EviCore to manage an additional preauthorization service for the Lab Management program for Health Alliance’s Commercial and Medicare members. For dates of service on or after August 1, 2019, providers must access EviCore on YourHealthAlliance.org to request preauthorizations. Providers can begin using EviCore through YourHealthAlliance.org on August 1, 2019 to submit these requests.

Beginning August 1^st, 2017, Health Alliance Medical Plans Commercial and Medicare members will require preauthorization from EviCore. Providers can begin requesting authorizations for services on July 14^th, 2017 for dates of service on and after August 1^st, 2017. Services performed without authorization may be denied for payment, and you may not seek reimbursement from members.

Preauthorization is required for:

• Sleep Studies
• Medical Oncology     
• Radiation Therapy
• Joint/Spine Surgery
• Pain Management
• Physical, Occupational, Speech, Chiropractic, Acupuncture, Massage
• Lab Management

Services performed in conjunction with an inpatient stay (with an exception of Joint & Spine Surgery), 23-hour observation or emergency room visit are not subject to authorization requirements. 

To request an authorization:

• Providers in the Health Alliance Medical Plans network will access EviCore throughYourHealthAlliance.org for providers.
• Out-of-network providers must call 1-844-303-8452 with preauthorization requests.

For urgent requests:

If services are required in less than 48 hours due to medically urgent conditions, please call 1-844-303-8452 for expedited authorization reviews. Be sure to tell the EviCore representative the authorization is for medically urgent care.

We recommend that ordering providers secure preauthorizations and pass the authorization numbers to the rendering facilities at the time of scheduling. Authorizations contain authorization numbers and one or more CPT codes specific to the services authorized. If the service requested is different than what is authorized, the provider must contact us for review and authorization prior to claim submission.

Have questions about requesting authorizations?

To learn more about requesting preauthorization, attend our online orientation. The orientation schedule and program training resources are available below. EviCore's Clinical Guidelines and request forms are available at YourHealthAlliance.org. For questions or additional information, call EviCore Customer Service at 1-844-303-8452, Monday through Friday, from 7 a.m. to 7 p.m. local time.