Pharmacy pre-authorization and medication information. Utilization management delegation At times, Regence will make a business decision to delegate utilization management activities to vendors or provider groups that have demonstrated an ability to manage those services. Interventional pain management procedures authorization by eviCore • For Medicare Plus Blue members: Effective for dates of service on or after Sept. 1, , unless otherwise noted, for adult members only (age 18 and older) • For select Blue Cross PPO’ (commercial) members: Effective for dates of service or after Jan. 1, , for. Interventional pain management procedures authorization by eviCore • For Medicare Plus Blue members: Effective for dates of service on or after Sept. 1, , unless otherwise noted, for adult members only (age 18 and older) • For select Blue Cross PPO’ (commercial) members: Effective for dates of service or after Jan. 1, , for. eviCore Prior Authorization Program. Blue Cross and Blue Shield of Texas (BCBSTX) has contracted with eviCore healthcare (eviCore)* to provide certain utilization management prior authorization services. Services prior authorization through eviCore are outlined below. To request an authorization, submit your request online, by phone or fax: Call eviCore at and choose option 4 for physicians. Here, providers may request or schedule a live peer-to-peer conversation. Please have the case or authorization number on the denial/fax letter ready. Log into ueptx.linkpc.net; Phone at Authorizations are valid for the time noted on each authorization response. WellCare may grant multiple visits under one authorization when a plan of care shows medical necessity for this request. Failure to obtain the necessary prior authorization from WellCare could result in a denied claim. For Implantable Cardiac Devices, Radiation Therapy or Musculoskeletal Services (large joint replacement, pain management and services), request authorization online with eviCore healthcare, or call eviCore healthcare Online. Enter online the eviCore Healthcare Web Portal which is available 24/7 ; Call between 6 a.m. to 6 p.m. (CST) Monday through Friday and 9 a.m. - noon Saturday, Sunday and legal holidays. Refer to the eviCore implementation site for more information. Payment may be denied if you perform procedures without authorization. The Provider/Customer and Authorization Request Submitter understand and acknowledge that violation of any provision of this Certificate Statement may subject the Submitter to suspension or permanent revocation of privileges enjoyed under an agreement with MedSolutions, Inc. the COVID pandemic, eviCore has increased their authorization span from 90 to days. Any authorizations that are already loaded into our system prior to eviCore their system will be updated on April 20, This will eliminate the burden of you as the provider to call and/or request a new authorization.
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Clinical Practice Guidelines - - Blue Cross Blue Shield of Texas
eviCore is committed to an evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics, and sensitivity to the needs of everyone involved across the healthcare continuum. Radiation Therapy: Medical Oncology: Sleep Management. Authorization Lookup: Eligibility Lookup: Help / Contact Us: Log In. Saturday, June 20, AM Authorization Lookup. OnePA: Prior Authorization Portal for .