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The most common reason in my experience why PA requests get denied, is quite simply a lack of information. For example, its very common for PA requests for MRIs or CTs to require that an X-ray and/or ultrasound be done first, to see if that will provide enough information for the doctor to treat the issue.
How do I submit a prior authorization to eviCore?
PA can be submitted through the eviCore web portal or by phone. Providers who are not registered on our website, should go to the web portal at (one-time registration is required). You are able to initiate a case, check status, review guidelines, view PA or eligibility, and more.
What insurance company uses eviCore?
Cigna works with eviCore healthcare (eviCore, formerly CareCore | MedSolutions) to provide high-quality, cost-effective services to Cigna customers in most markets for outpatient, nonemergency, high-technology radiology and diagnostic cardiology services.
Why is it so hard to get a prior authorization?
Prior authorization (prior auth, or PA) is a management process used by insurance companies to determine if a prescribed product or service will be covered. This means if the product or service will be paid for in full or in part.
Why are prior authorizations so difficult?
Shifting rules and overall payer complexity make it difficult for health systems to stay ahead of what they need to get prior authorization requests approved, which lengthens the time an auth takes and results in more denials.
evicore authorization form
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Before requesting prior approval from please have the patients medical records on hand and complete the request form specific to the procedure being requested.
PA (prior authorization) requests for advanced imaging services are approved by eviCore healthcare for a period of 60 calendar days from the grant date.
OHSU Health Services Prior Authorization List Effective 03/
Mar 1, 2022 Please note that this list encompasses ALL authorizations. (Codes that must be processed by OHSU Health Services in-house, eviCore and Magellan.)
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