Martin's Point

​EviCore healthcare (EviCore) is pleased to announce its partnership with Martin’s Point Health Care to provide preauthorization services. ​

Effective September 18th 2017, EviCore healthcare will administer all prior authorizations for Generations Advantage Medicare Advantage plan members with dates of service beginning October 1, 2017. ​ Pursuant to the terms of your Participating Provider Agreement, services performed without authorization may be denied for payment, and you may not seek reimbursement from members. Authorization is required for: 

• MRI/MRA
• CT/CTA​
• PET
• Ultrasound (non-OB)
• NCM/MPI (Nuclear Cardiac Imaging)
• ​Nuclear Medicine​
• Stress Echocardiograms
• Cardiac Imaging (MR, PET, CT)

Services performed in conjunction with an inpatient stay, 23-hour observation, or emergency room visit are not subject to authorization requirements. 

To request an authorization:

• Log onto www.evicore.com/pages/ProviderLogin.aspx
• Call EviCore at 1-888-693-3211

For urgent requests:
​ ​If services are required in fewer than 48 hours due to medically urgent conditions, please call the toll-free number for expedited authorization reviews. Be sure to tell the representative the authorization is for medically urgent care.

It is recommend that ordering physicians secure authorizations 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 authorized services. If the requested service is different from what is authorized, the rendering facility must contact EviCore healthcare for review and authorization prior to claim submission.​​