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August 2020

eviCore simplifies authorization process for radiation oncology

Beginning July 1, 2020, eviCore healthcare® simplified the authorization process for radiation oncology so that you’ll see fewer clinical questions on authorization requests.

As part of the process, eviCore will be asking clinical decision support questions, rather than traditional clinical questions. This change applies to authorizations for breast, prostate and non-small-cell lung cancer.

What you need to do
The steps to submit authorization requests to eviCore won’t change. You’ll log in to the eviCore portal at evicore.com,** initiate a request for Clinical Certification for Radiation Therapy and enter information about the member.

For breast, prostate and non-small-cell lung cancer, the system will prompt you to answer the CDS clinical questions. Then you’ll select a treatment regimen from provided options or enter a custom treatment regimen.

Additional information
eviCore manages authorizations for radiation oncology for most fully insured Blue Cross commercial groups and for Medicare Plus BlueSM, BCN commercial and BCN AdvantageSM members.

For more information, see the Blue Cross eviCore-Managed Procedures or the BCN eviCore-Managed Procedures pages of the ereferrals.bcbsm.com website.

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