New Process in 2022 for Specialized Therapy Requests
Effective January 3, 2022, eviCore is updating its clinical collection process
for specialized therapy requests. This will include clinical pathways for
musculoskeletal and OT/PT pediatric neurodevelopmental conditions. This
change requires less information, increases the opportunity for a real-time
decision if criteria is met, and standardizes the clinical collection process
for all health plans. Revised clinical worksheets will be available at eviCore.com.
Individual Plans use a separate code list,
prior authorization tool, and online submission tool Identifi (not eviCore). Sign in to Individual Plan tools.
Check our code list to view outpatient rehabilitation codes. If no results are found, the code doesn't require review. We review non-specific codes when the claim is submitted.
To create an account and/or initiate an authorization:
Visit eviCore healthcare for:
eviCore healthcare is an independent company managing outpatient rehabilitation services for Premera providers.