Network Health Wisconsin Provider Resources

EviCore by Evernorth is in partnership with Network Health Wisconsin to provide authorization services for Network Health members.

Outpatient MR, CT, PET, Outcomes Focused Cardiology and Lumbar Spinal Fusion Surgery studies require prior authorization from EviCore healthcare.

Note: With Lumbar Spinal Fusion Surgery and some joint surgeries, the member may have an inpatient stay. EviCore by Evernorth is limited to authorizing the procedure only. Please submit the request for inpatient hospitalization to Network Health.

Medical Oncology (including Lab), Radiation Therapy, Joint Surgery, Spine Surgery and Interventional Pain services require prior authorization from EviCore by Evernorth.

Physical Therapy, Occupational Therapy and Gastroenterology services require prior authorization from EviCore.

Beginning December 11, 2023, EviCore will begin accepting prior authorization requests for the Peripheral Vascular Disease diagnosis and/or intervention procedures and Spine surgery services for dates of service beginning January 1, 2024 and after.

EviCore will also be migrating services currently managed on the MedSolutions side of the portal to the CareCore National side of the portal.  Access to either portal rely on the same user sign on credentials through www.EviCore.com/provider.  Programs impacted for Network Health users include Radiology, Cardiology, and Musculoskeletal (MSK) requests. Effective December 11, 2023, these authorizations will be managed on the CareCore National side.  Authorizations built prior to December 11, 2023 on the MedSolutions Portal will remain there for reference.