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eviCore healthcare

Empowering the Improvement of Care

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Overview

eviCore, part of Evernorth, is a specialty medical benefits management company that partners with health plans to manage care and costs. They provide prior authorization services across various specialties like radiology, cardiology, and oncology, using evidence-based clinical guidelines to ensure appropriate care. Providers can submit authorization requests through eviCore's online portal.

✨ Key Features

  • Utilization Management
  • Prior Authorization for specialty care (Radiology, Cardiology, etc.)
  • Evidence-based Clinical Guidelines
  • Provider Portal
  • Site of Care Optimization

🎯 Key Differentiators

  • Deep clinical expertise in specific medical specialties
  • Comprehensive, evidence-based guidelines
  • Long-standing relationships with major health plans

Unique Value: Ensures appropriate, cost-effective care in complex medical specialties through the application of rigorous, evidence-based clinical guidelines.

🎯 Use Cases (3)

Managing utilization for high-cost medical specialties Providers submitting prior authorization requests for services managed by eviCore Health plans outsourcing specialty benefits management

✅ Best For

  • Managing benefits for over 100 million patients on behalf of health plans.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Providers looking for a multi-payer tool for all authorization types (eviCore is payer-specific)

🏆 Alternatives

Cohere Health AIM Specialty Health (Elevance Health) NIA (Magellan Health)

Offers deeper clinical specialization and a more comprehensive approach to utilization management compared to general-purpose authorization platforms.

💻 Platforms

Web

🔌 Integrations

Health Plan (Payer) systems

🛟 Support Options

  • ✓ Email Support
  • ✓ Live Chat
  • ✓ Phone Support
  • ✓ Dedicated Support (N/A tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ URAC ✓ NCQA ✓ HITRUST

💰 Pricing

Contact for pricing
Free Tier Available

Free tier: Free for providers to submit requests to payers who contract with eviCore.

Visit eviCore healthcare Website →