WellSense Health Plan Implementation Resources
Effective Date: 1/1/2025
Program: MEDICAL SPECIALTY DRUGS (NON-ONCOLOGY)
For: WELLSENSE NEW HAMPSHIRE MEDICARE ADVANTAGE AND WELLSENSE CLARITY NEW HAMPSHIRE PROVIDERS
PRIOR AUTHORIZATION CASE INITIATION:
o Additional information located under SOLUTION RESOURCES
EviCore is pleased to announce that it has extended its partnership with WellSense to provide prior authorization services for Genetic Testing and MSK Pain Management, Spine and Joint Surgery for dates of service on and after 3/1/23.
EviCore is pleased to announce its partnership with WellSense Health Plan to provide authorization services for WellSense recipients for dates of service beginning Sunday, December 1, 2013.
All outpatient elective MR, CT, PET, and Nuclear Cardiac studies performed on or after December 1, 2013 will require prior authorization from EviCore healthcare.
EviCore currently accepts Radiology and Cardiology prior authorization requests for WellSense members through the MedSolutions portal. Beginning 1/1/25, these requests should be entered through the CareCore National portal at EviCore.com.
Cardiovascular
Radiology
Laboratory Management
Musculoskeletal
Medical Specialty Drugs
Need Help?
Registration Instructions
EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.