Save Time by Using eviCore Web Portal for Prior Authorization Requests

April 25, 2019

Blue Cross and Blue Shield of (BCBSTX) contracts with eviCore (eviCore), an independent specialty medical benefits management, for select specialty utilization management services.

After you use Availity® or your preferred and determine the service for your member requires prior authorization through eviCore, you can save a lot of time by submitting preauthorization requests through eviCore’s provider portal. eviCore recently made several improvements to make requests even easier.

Submitting a request through the eviCore provider portal helps make sure the request is submitted correctly and includes the needed information, which help the approval process go more smoothly. Using the eviCore provider portal to submit requests for prior authorization also allow you to:

  • Save time — an authorization request initiated on the eviCore provider portal is three faster than a phone request
  • Access requests — submit requests and check their progress when it is convenient
  • Stop and start as needed — save your authorization request and return to it later
  • View and print authorization information — see details for the approval and the case number
  • Review clinical — see what is required to secure a prior authorization, including what procedures codes require prior authorization
  • Upload member’s medical records — upload clinical information if needed
  • Schedule consultations — schedule a Clinical Consultation through the portal if you have questions.

To begin managing eviCore authorizations, go to eviCore.com and register. Training sessions are available through the eviCore training center .For provider portal help, portal.support@evicore.com or call 1-800-646-0418 and select option 2.

Important Reminder: Always Check Eligibility and Benefits First
Benefits will vary based on the service being rendered and individual and group policy elections. It is critical to check eligibility and benefits for each patient to confirm coverage details. This step will also identify benefit prior authorization/pre-notification requirements and specify utilization management vendors that must be used, if applicable. Submit online eligibility and benefits requests (electronic 270 transactions) via the Availity Provider Portal or your preferred web vendor portal.

 

eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSTX. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third-party vendors such as eviCore, Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.