As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected,
we will be implementing changes to evicore.com in the near future.
Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status
of authorization request(s). Please click here to register for an account.
eviCore’s Post-Acute Care solution provides a patient-centered approach that expands upon standard utilization review and prior authorization processes to fully coordinate the post-acute recovery process. We help patients receive the right care in the most appropriate setting by applying evidence-based guidelines to determine the appropriate level and site of post-acute care. The ultimate goal is to transition the patient to their home in a timely manner. Our solution supports the patient throughout the entire care continuum.
Our patient-centric, comprehensive solution provides an individualized plan of care across the most appropriate continuum of post-acute care. We manage patient cases from day one of the inpatient stay to 30-, 60-, or 90-days after discharge from the acute setting.
Our Post-Acute Care solution relies on clinical protocols that utilize nationally recognized evidence-based guidelines. Our unmatched experience in care management and uUtilization Management UM ensures improved clinical outcomes, lower readmission rates, and enhanced care coordination.
eviCore’s Post-Acute Care solution works closely with the patient, their caregivers, and providers throughout the duration of the care continuum. This staying power enables us to better manage quality of care, cost, and readmission risk, while improving both patient and provider satisfaction.
Our current Skilled Nursing Facility (SNF) payment model is consistent with the new SNF payment model that CMS is mandating beginning October 2019.
Our nurse care managers begin engagement prior to hospital discharge, bringing evidence-based guidelines specific to the patient’s recovery needs into the discharge planning discussion. We involve patients, patient’s families, their doctor and nurse teams, and community resources to create the most supportive and consistent recovery plan available.
eviCore’s Telehealth and Remote Patient Monitoring offers several communication tools for patients and caregivers. Patients can interact with their clinician through text messaging, voice calling, and video conferencing.
In addition to these communication platforms, eviCore’s Transitional Care Team will make telephonic outreach to members. Telephonic outreach from eviCore is patient-centered. A customized call plan with your eviCore Care Coordinator will be developed on your first call.
eviCore’s Telehealth and Remote Patient Monitoring program features several key goals and benefits for our members and for our partnering healthcare providers:
Each day, members will be expected to record their medications, vital signs, and symptoms on the tablet provided to them. Members may also be asked to watch a short video on their condition to help educate them on their symptoms and how to manage their care.
By clicking the link below, you can read about one member's journey on the Telehealth and Remote Patient Monitoring program.
eviCore’s Post-Acute Care solution was developed to close the existing care gaps within the post-acute care continuum. Our solution eliminates inefficiencies, reduces cost, focuses on transitional care efforts, and improves the quality of patient care. The post-acute services include:
eviCore facilitates the delivery of post-acute care services in the most appropriate setting based on the patient’s medical necessity. The frequency of transitional care touchpoints is based on each patient’s clinical needs and the nature of the post-acute care setting. The modes of communication used may include in-person contact, telephonic, secure email/text, or a combination of methods.
Our teams of medical directors, RNs, and their support teams utilize a proprietary case management system built specifically for managing post-acute care using evidence-based and CMS guidelines.
A broad range of members are eligible to receive enhanced at-home care through Telehealth and Remote Patient Monitoring. eviCore members with chronic conditions or multiple comorbidities, recovering from surgery, or at an increased risk for hospitalization may be offered enrollment in the Telehealth and Remote Patient Monitoring program.
Qualifying conditions include:
The continuum of care from hospital to home can be very fragmented, involving many teams of caregivers, multiple post-acute providers and services, as well as various home-health options. Each step of the post-acute decision process can be complex and provide a significant risk for re-hospitalization or a setback to clinical progress. Our post-acute solution has been developed to proactively identify hazards to successful recovery and provide one consistent source of support throughout the care continuum.
Our Post-Acute Program is patient centric, we work directly with the patient and family to establish goals for the care in a PAC facility and Home. Our Transitional Care Program provides members with education needed to remain safely in home. Our remote patient monitoring program will help reduce readmissions with real time access to member information.