Ask EviCore: Portal Support | EviCore by Evernorth (2024)

Happy New Year! I’m Mark Tate, and my team works hard to make sure your experience working with EviCore is easy, fast, and collaborative. We welcome your feedback on how we’re doing and appreciate suggestions for future topics of this column.

Our topic for this month’s Ask EviCore is the EviCore web portal. Using the EviCore web portal is the most efficient way to initiate requests for prior authorization and check the status of an existing request. Our self-service web portal is available 24/7, enabling you to initiate and review authorization information at your convenience. We’re answering some of the most commonly asked questions that our portal-support team receives.

How do I access the portal?

The portal login can be found on the homepage at www.evicore.com, or on the Provider’s Hub page at https://www.evicore.com/provider. You will need to make sure the pop-up blocker is turned off in your web browser, or you will be unable to log-in to the site. The Provider’s Hub is a great resource for provider offices, and we encourage you to check it out.

If you are a new user and need to create an account, visit: https://myevicoreportal.medsolutions.com/User/Registration/Index.

Brief video tutorials to help you register on the portal can be found on the Provider’s Hub at: https://www.evicore.com/provider. Scroll down to the “Video Tutorials” section.

How can I change or update my password?

The easiest way to reset your password is by clicking “Forgot Password?” on the login dropdown. (This can be found in the green bar in the top-right corner of every page on the EviCore website.) The system will then send an automatic email to the registered email address with a link for setting your new password. If you do not receive the link, please use the Chat feature available at the bottom right-hand of the screen on the login page. You can also email us at portal.support@evicore.com, or reach us by phone at 800-646-0418, option 2.

Which platform should I use for this case – MedSolutions or CareCore?

If you scroll down the Provider’s Hubpage, you’ll see an option called, “I want to learn how to …” From the drop-down menu, select: “Start a New Prior Authorization.” You will need to select the health plan and the solution and then choose Start, and you will be directed to the platform you should use to submit a prior authorization request for your patient.

How can I check the status of a case?

At www.evicore.com you’ll find a handy shortcut in the green bar at the top right-hand of the page. Select, “Check Prior Authorization Status.” You will need to enter the health plan and click “Submit.” Then enter the Patient ID and Date of Birth, and click “Search.”

Regardless of the platform (and associated portal), users will need to log-in to see all of the available information on the case. Each portal offers a user worklist that will display all of your in-progress prior authorization cases. In the MedSolutions portal, the worklist can be found on the Home page. In the CareCore portal, you’ll find it under the Certification Summary tab. The worklist is searchable, and you can double-click into any case on your worklist. The date window can also be changed to show cases in the 7-, 14-, or 30-day window.

In 2018, we also rolled out a feature that allowed users of the CareCore National portal to create prior authorization requests that included multiple CPT codes (applies to Radiology and Cardiology managed through EviCore healthcare only). Since then, we’ve learned that many of you weren’t aware this helpful feature existed, so we wanted to send a reminder along with some easy-to-follow instructions to get you started. We also created a “Creating a Request with Multiple CPT Codes How-To Guide”.

Once you’ve logged in, you will be able to submit additional clinical information for a prior authorization case that is already in progress. Once inside the portal, select Search/Start Case and then click the “additional clinical upload” option.

How do I sign up for training?

EviCore Provider Orientation Sessions are free, last approximately one hour, and are usually offered on Tuesdays and Thursdays each week. All sessions are scheduled in Central Time. Please register in advance.

You can view the upcoming schedule and register for a webinar session here: https://evicore.webex.com/mw3300/mywebex/default.do?siteurl=evicore&service=7.

  • Select the “Upcoming” tab. In the search box above the tabs, type: EviCore Portal Training.
  • Choose the date and time for the session you would like to attend, and click the “Register” link beside it. (You will need to register separately for each session).
  • Complete the required information, and click the “Register” button.

Immediately after registering, you will receive an email containing the toll-free phone number, meeting number, conference password, and a link to the web portion of the conference. Please keep the registration email so you will have the web-conference information for the session in which you will be participating.

Who do I contact if I need help?

A chat feature is available on select pages of the website from 7a.m. to 8 p.m., ET, Monday - Friday. You can also email portal.support@evicore.com or call 800-646-0418, option 2.

Quick Links:

Here are a couple of quick links to help you get where you need to go fast.

Do you have any questions, feedback, or suggestions on how EviCore can improve the prior authorization process or the provider experience? Please share your feedback with Jackie Jenkins, the National Provider Advocate on my team, atprovidernewsletter@evicore.com. We also encourage you to email your ideas for future Ask EviCore columns.

Thank you for your continued partnership with EviCore. Together, we can help ensure your patients get the best possible care.

Mark Tate
Master of Physical Therapy
Vice President, EviCore Provider Experience
Ask EviCore: Portal Support | EviCore by Evernorth (2024)

FAQs

How do I contact EviCore for prior authorization? ›

How can I initiate a prior authorization request? The quickest, most efficient way to obtain prior authorization is through the 24/7 self-service web portal at www.evicore.com. Prior authorization can also be obtained via phone at 855.252. 1117.

Is EviCore part of Evernorth? ›

EviCore by Evernorth is an independent utilization management company that provides preauthorization for selected care categories.

What is EviCore portal? ›

Using the EviCore web portal is the most efficient way to initiate requests for prior authorization and check the status of an existing request. Our self-service web portal is available 24/7, enabling you to initiate and review authorization information at your convenience.

What is the turnaround time for EviCore prior authorization? ›

In the event of clinical urgency, eviCore healthcare will render a decision within 72 hours of the request. What is the decision time limit for a routine prior authorization decision? eviCore healthcare will render a decision on a routine prior authorization request within 14 calendar days of the original request.

How can I speed up my prior authorization insurance? ›

16 Tips That Speed Up The Prior Authorization Process
  1. Create a master list of procedures that require authorizations.
  2. Document denial reasons.
  3. Sign up for payor newsletters.
  4. Stay informed of changing industry standards.
  5. Designate prior authorization responsibilities to the same staff member(s).

How do I submit a prior authorization on availity? ›

Requesting authorizations on Availity* is a simple two-step process. Here's how it works: Submit your initial request on Availity using the Authorization (Precertification) Add transaction. Complete a short questionnaire, if asked, to give us more clinical information.

Who is Evernorth owned by? ›

The Evernorth brand is anchored by Evernorth Health, Inc., a wholly-owned subsidiary of Cigna Corporation, and the parent company of the Express Scripts, Accredo, and eviCore companies.

What insurance company uses eviCore? ›

EviCore by Evernorth partners with Cigna to provide industry-leading benefit management solutions for key medical segments, including advanced radiology imaging, diagnostic cardiology, radiation therapy, and musculoskeletal services.

Is Cigna now called Evernorth? ›

Cigna rebrands as The Cigna Group (and launches two health care brands) The health benefits provider is evolving to Cigna Healthcare and Evernorth, which includes Express Scripts, will now operate as Evernorth Health Services.

Is eviCore legit? ›

This distinction validates that EviCore healthcare meets stringent national standards in the areas of staff qualifications, program content and processes, patient confidentiality, accessibility and documentation.

What did eviCore used to be called? ›

Effective June 5, 2015, CareCore National, LLC has changed its name to eviCore healthcare®.

Why is eviCore healthcare calling me? ›

EviCore's representatives are calling to offer choices about where you can receive your medical scan. Many of our partner health plans offer their members additional information about cost-effective and convenient locations.

Why do prior authorizations get denied? ›

If a service is being denied by most health plans, you may have a systems problem such as improper coding practices. If the denial is coming from only one health plan, contact the plan and find out what their coverage position is on that particular procedure or drug.

How long does the average person spend on prior authorization? ›

On average, practices complete 45 prior authorization requests per physician, per week. Physicians and their staff spend an average of 14 hours—almost two business days—completing those requests each week. 35% of physicians have staff who work exclusively on prior authorizations.

What is the phone number for EviCore pre-authorization? ›

To request an authorization:

Call EviCore at 1-888-693-3211.

How do I upload documents to EviCore? ›

Upload Information

Login to your account at https://www.evicore.com/provider. Select the CareCore National portal and then select authorization lookup and upload additional clinical.

How to check authorization status on availity? ›

Log into Availity Essentials to access the Authorizations and Referrals application. From the Patient Registration menu at the top of the screen, select Authorizations & Referrals. You will see Auth/Referral Inquiry and Auth/Referral Dashboard on the screen, along with other choices.

What is the other name for EviCore? ›

Effective June 5, 2015, CareCore National, LLC has changed its name to eviCore healthcare®.

What is the EviCore process? ›

A process by which EviCore makes an evidence-based determination regarding whether a particular requested healthcare service or supply should be covered under a Member's healthcare benefits coverage (which may include, among other items, Medical Necessity determinations).

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