Implant Management | Payment Integrity

Managing Cost

A key component of eviCore’s innovative programs for managing implant costs rest on insight info—and oversight of—implantable device claims. eviCore addresses the discrepancies in implant-related claims that can contribute to wide variations in cost for surgeries involving implants.

Claim Review Process

To combat implant cost problems, eviCore utilizes a 4-level claims-review process:

Outlier analysis based on cost
Pricing benchmark analysis
Intra-operative variability check
Technical review with internal experts.

Benefits

eviCore promotes transparency and predictability into device spend, while lowering medical costs for clients and patients. At the same time, our Implant Management program promotes safety and quality with our recall database—a differentiator in the marketplace, as it offers health plans a centralized view of recall information.

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Health Plans | Payment Integrity Implant Management

Managing Cost

Claim Review Process

Benefits