Limited Distribution Specialty Drug List | covered prescriptions formulary drugs medications accredo acredo |
Allergy Benefit Extension Request | |
Appendix B: Laboratory Guideline to Approved In-Office Laboratory Tests | provider manual clia tests in office in-office labs |
Benefit Fund Appeal Representation Authorization Form | claims appeals denial designate designation grant |
Cardiac/Pulmonary Rehabilitation Request | |
CareAllies Initial Pre-Certification Request | care allies pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
CareContinuum Medical Benefit Management Program | care continuum |
Medical Management for Chiropractic Services - Quick Reference Contact Sheet | |
Medical Claim Reconsideration Request | claims appeals |
eviCore Codes Requiring Authorization | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization out patients outpatients precertification certification pre-certification authorize authorizing |
Codes Under eviCore Radiation Therapy Review Program | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Complete Code List under eviCore Laboratory Management Program | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Co-Pays for Greater New York Members | what's what is the gny copays copayments co-payments for a primary care office visits appointments general family internal medicine practitioners pediatricians OB/GYNs geriatricians adolescent medicine providers prescriptions drugs medications preventive services |
eviCore Contrast Agents and Radiopharmaceutical | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
eviCore Radiology and Cardiology Diagnostic Claims Studio Procedure Codes | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
eviCore Laboratory Management Program FAQs | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing frequently asked questions |
eviCore Medical Oncology Primary and Supportive Drug List | covered prescriptions medications evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing oncology primary and supportive therapies drugs list clinical pathway precertification certification pre-certification reference document |
eviCore Medical Oncology Review Program FAQs | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing quick reference guide frequently asked questions |
eviCore Lab Management Quick Reference Guide | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing laboratory laboratory |
eviCore Radiation Therapy Clinical and Coding Guidelines | evicore evi core carecore care |
eviCore Radiation Therapy Clinical Documentation Requirements | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
eviCore Radiation Therapy Management Program Quick Reference Guide | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing quick reference guide |
eviCore Radiation Therapy Review Program FAQs | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing frequently asked questions |
eviCore Radiology and Cardiology Diagnostic Services Prior Authorization Procedure Codes | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing evi core carecore care |
eviCore Radiology Review Management Program | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing quick reference guide |
eviCore Radiology Review Program FAQs | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing frequently asked questions |
FAQs: 2013 Behavioral Health Code Changes and the Mental Health Parity Law | evi core carecore care frequently asked questions |
Focus DRG Validation Program | Readmission Review Programs |
Request for Home Oxygen Authorization | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
HomeCare, Certain Outpatient, DME and Rx Services | durable medical equipment drugs covered prescriptions home care out patients outpatients medications pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Hospital Claim Reconsideration Request Form | HCPCS icd10 icd-10 cpt drg appeals claims |
CareAllies Medical Management for Hospital Services - Quick Reference Contact Sheet | care allies |
IRS Form W-9 | w9 taxes |
Laboratory Management Clinical Policy Manual | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
CareContinuum Medical Benefit Management Program Specialty Drug List | covered prescriptions formulary drugs medications ExpressPAth express path carecontinuum care continuum pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Outpatient Services and/or Ambulatory Surgical Procedures that Require Pre-Authorization | out patients outpatients pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Preferred Drug List (PDL) | covered prescriptions formulary drugs medications prefered preferred |
Prescription Request for Authorization | covered prescriptions medications drugs pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Provider Demographic Information Change Request Form Guide | how do i we to change update add my our Billing service address? Business? Name? tax id tin w9 w-9 npi instructions help guide guidance |
Provider Demographic Information Change Request Form | how do i we to change update add my our Billing service address? Business? Name? tax id tin w9 w-9 npi |
Provider Manual | instructions help |
Provider Quick Reference Guide | instructions help policy cheet sheet |
Provider Recruitment Form | how do I we sign up |
Radiation Therapy Prior Authorization and Claims Studio Procedure Codes | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Radiation Therapy Tools and Criteria | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
Radiology Criteria (eviCore healthcare’s evidence-based clinical guidelines) | evi core carecore care pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing policy |
Radiology Privileging List | Privileging standards by specialty cpt codes |
Service/Equipment Request for Authorization | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |
The 90-Day Rx Solution | 90 day covered prescriptions drugs medications |
NYC PICA Drug List (for LPN Members and NYC municipal employees only) | covered prescriptions formulary drugs medications prefered preferred new york city lpn licensed practical nurses welfare fund |
90-Day Rx Solution Maintenance Drug Access Program Waiver Request Form | 90 day maintenance covered prescriptions formulary drugs medications prefered preferred exception prior authuthorization priorauthorization prior-authorization preauthorization pre-authorization |
Utilization Management Master Drug List | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization outpatients precertification certification pre-certification authorize authorizing um accredo acredo pica nyc employees new york city qty quantity limited express scripts expressscripts evicore evi core cancer oncology split fill step therapy client |
Pharmacist Authority to Administer Vaccines by State | vaccinations vacines vacinations |
Prescription Claims Reimbursement Form | covered prescriptions claims formulary drugs medications prefered preferred new york city lpn licensed practical nurses welfare fund hmo plans retail pharmacies pharmacy |
Transcranial Magnetic Stimulation (TMS) Pre-Authorization | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization out patients outpatients precertification certification pre-certification authorize authorizing |
PT/OT/ST & Acupuncture Request | pre prior authorization preauthorization priorauthorization pre-authorization prior-authorization precertification certification pre-certification authorize authorizing |