Medical Mutual of Ohio Resources

Medical Mutual has expanded its engagement of EviCore healthcare (EviCore) to manage the prior authorization process for radiation oncology services for our fully insured and self-funded group members, including those in commercial, individual and Medicare Advantage plans.

What Is Changing

The transition to EviCore for radiation oncology prior authorizations will begin for dates of service on or after Feb 1, 2022. EviCore will start accepting prior authorization reviews on Jan. 17, 2022. If treatment starts prior to Jan. 17th, there are no changes in prior authorization requirements, and providers should continue to submit requests to Medical Mutual directly.

Please note that we have expanded the list of radiation oncology services that will be subject to prior authorization. A complete list of services that require prior authorization through EviCore is available at MedMutual.com/Provider or https://www.evicore.com/resources/healthplan/medical-mutual-of-ohio  Services performed in conjunction with a 23-hour observation, emergency room visits or inpatient hospital stays are not subject to prior authorization requirements.