Patients

eviCore is committed to improving the quality and the value of patient care by offering integrated, innovative medical benefits management (MBM) solutions that deliver the needed services and products as quickly and efficiently as possible.

  

Focusing on patients like you, to provide better outcomes

When you are sick or in pain, you want to find a solution and fast. But some solutions are better than others, and some solutions are safer than others. You deserve to know the options.
You deserve the best medical care.
eviCore serves more than 100 million members in the United States today. We work with and support doctors or care givers so that patients receive the most appropriate medical care based on their unique clinical situation. We rely on our 25 years of experience and proven evidence-based guidelines to ensure that patients receive the right care, at the right time, and at the right place. With eviCore, you can feel confident that your clinical well-being will always be in the right hands.
  

We’ve Got Your Back

Patient safety is one of our top priorities. Along your course of care, we will monitor each phase of treatment to promote physician best practices and ensure that you are not exposed to unnecessary therapies.

Patient Empowerment: Is that procedure right for me?

We encourage patient empowerment through education and patient engagement. Patients may be unaware of the potential health risks associated with many procedures requiring prior authorization. eviCore wants you to not only be aware of these health risks, but also understand how they can affect your life.
  

Reducing Waste and Containing Cost

In addition to the health risks associated with many of the procedures that require prior authorization, there are also major (and at times, unnecessary) financial risks. Inappropriate utilization, inefficiencies in healthcare, and quality-lacking processes all contribute to the increase in waste and high-cost therapies in healthcare. Our patient-centric approach ensures your individual treatment(s) are necessary, thus maintaining costs to only those treatments appropriate to you.
  

Patient FAQs

Why didn’t you call me last time when I had a procedure?

We only contact patients when there are lower cost facilities available in their area for participating health plans.

I got a message from a SmartChoiceSM representative asking me to call back; why are you calling me?

A SmartChoiceSM representative may call you to offer choices about where you can receive your medical scan. Many of our partner health plans use our SmartChoiceSM patient engagement program, which informs their members about options for cost-effective and convenient locations. All referred locations are accredited, to ensure they meet the highest standards for quality and safety. We called to let you know there are a few near you that can provide the same service to you, at a lower cost.

Helping and Empowering Patients

Patient satisfaction is one of our top priorities. Through patient engagement, we help ensure that you are well informed prior to making important choices regarding your health. Our commitment is evident in the testimony of actual patients who have benefited from the SmartChoiceSM program and are sharing their positive experiences.

Collaborating As Your Ally

SmartChoiceSM is a support patient-engagement program that educates patients, like you, about the real options available when choosing a location for radiology healthcare services. The program empowers you to select same-quality diagnostic imaging procedures at more cost-effective and geographically convenient facilities.

You can save by deciding where you receive your services. SmartChoiceSM program personnel also serve as an outreach concierge; while their primary role is to ensure that you are thoroughly educated about your imaging service, they can also make all of the scheduling arrangements on your behalf. You and your doctor, of course, will always ultimately choose where to have these services performed. After that, our concierge-like support can manage all administrative tasks, ensure that all the necessary pre-approvals are in place, and guide you through the process, from start to finish.

SmartChoiceSM

In today’s more complex healthcare environment, patients trying to access and understand information about the quality and value of their health services need an ally. They need patient engagement tools and services that can help them make smart decisions about their healthcare and how their money is spent. For example, patients should know that for the same-quality radiology services, the costs and convenience can vary greatly among locations. An educated patient can choose the best available option.

Empower Patients to Better Outcomes

The SmartChoiceSM program works collaboratively with you and your doctor to ensure the best possible outcome for you. Through the SmartChoiceSM program, you experience the following benefits:

  • Individualized care from knowledgeable SmartChoiceSM personnel​
  • Concierge-like support providing conveniently located, in-network facilities that can perform the services you need
  • Scheduling assistance at the lower cost facility.

The SmartChoiceSM program is your support and outreach program available to educate you about your options when receiving radiology healthcare services at more cost-effective and geographically convenient facilities.

How did you get my phone number/information?

As part of your coverage, authorization and scheduling of MRIs, CTs, and PET scans must be reviewed by our radiology specialists prior to the service being provided. Your doctor's office contacted us about your scan and gave us your phone number.

Don’t I have to go to a hospital for my procedure?

No, you can have your procedure at a location convenient to you.

How will my doctor know where I am going?

Once you have selected a facility we will send a fax, including your authorization number, to your doctor’s office and the facility you have selected.

If my request is not approved, how will I receive my notice?

If there is an adverse determination issued the member will receive their notice in writing.