Network Health WI Provider Resources

EviCore by Evernorth is pleased to announce its expanded partnership Network Health to provide services for members enrolled in their Medicare program. The prior authorization program will provide Medicare patients with access to high quality, medically appropriate care that is consistent with evidence-based treatment guidelines.

Cardiac Imaging (new for Medicare members) and Cardiac Implantable Devices - New Prior Authorization Requirements Beginning July 1, 2026 

To mitigate risks related to our significant membership growth as well as the expansion of our provider network, Network Health is expanding prior authorization requirements. 

Effective July 1, 2026, the following services will require prior authorization from EviCore by Evernorth for Network Health members.

• Cardiac Imaging - for our Medicare lines of business (this requirement is already in place for all commercial membership)
• Cardiac Implantable Devices - for all Medicare and Commercial members in all lines of business

EviCore employs board certified specialists, including cardiologists and cardiothoracic surgeons, for peer review of these requests.  Peer to peer discussions can be scheduled at your convenience directly with the reviewing physician.  EviCore guidelines are evidence-based. As with all services, Network Health will conduct regular review to determine efficacy of the program to evaluate continuation or discontinuation.

If you have questions about requesting authorization, please plan to attend one of our online orientation trainings. The orientation schedule and program training resources will soon be available. Please look for future communications with this information.