Sessions offered May and June. Please click here to register for an account. Why would I switch to intelliPath ePA? Step 1 Confirm if Prior Authorization is Required. If urgent (after-hours) call 866-322-6287 , from 9 p.m. to 9 a.m., Monday through Friday. Highmark requires authorization of certain services, procedures, and/or Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) prior to performing the procedure or service. Well before the pandemic, consumers were leaning towards home healthcare versus facility based care when appropriate for a number of reasons. Prior authorization is a process that is often criticized for denying carebut is actually designed to protect patients by ensuring they get the right care. Echocardiograms also just so happen to be one of the most common inappropriately ordered tests. The system can easily be made an extension of the clients existing claims workflow. Specialized therapies such as chiropractic, acupuncture, and physical therapy are cost effective, and can provide improved outcomes for chronic pain patients. its a guideline to help us practice medicine better, and to keep safety in mind for our patients by not over utilizing explains Dr. Robert Good, VP & Associate Chief Medical Officer for Carle Health, on how eviCores solutions have made a difference for their patients in the newest Auth the Cuff podcast. A prior authorization isnota guarantee of benefits or payment. If you donotget prior approval via the prior authorization process for services and drugs on our prior authorization lists: When and how should prior authorization requests be submitted? \u003ca href=\"https://content.highmarkprc.com/Files/NewsletterNotices/SpecialBulletins/sb-post-phe-provider-communication.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"\u003e\u003cstrong\u003eCLICK HERE\u003c/strong\u003e \u003c/a\u003efor the details.\u003c/p\u003e","visible":false,"archive":false,"liveStatus":2}], Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (, Examples of services that may require authorization include, Potentially experimental, investigational, or cosmetic services, Select injectable drugs covered under the member's medical plan, Select Not Otherwise Classified (NOC) procedure codes, i.e., unlisted, miscellaneous, Not Otherwise Specified (NOS). To check on the status of an authorization, please visit our provider secure web portal. Highmark will provide written notice when codes are added to the list; deletions are announced via online publication. eviCores new electronic prior authorization eviCore intelliPath is already being deployed inside the existing prior authorization workflow and by provider organizations to automate and simplify the process of submitting and tracking requests for prior authorization. % Contact Us | UHCprovider.com Benefits will be determined once a claim is received and will be based upon, among other things, the members eligibility and the terms of the members certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. All Rights Reserved. of authorization request(s). Outpatient: 1-844-442-8012. You're being redirected to the CMS search site. EmblemHealth Preauthorization List. *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * Terms of Use | * eviCore is a trademark of eviCore healthcare, LLC, formerly known as CareCore, an independent company that provides utilization review for select health care services on behalf of BCBSTX.
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