{"id":3496,"date":"2017-07-31T17:11:44","date_gmt":"2017-07-31T17:11:44","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=3496"},"modified":"2017-07-31T17:14:36","modified_gmt":"2017-07-31T17:14:36","slug":"how-to-obtain-prior-authorization-for-molecular-genomic-testing","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/how-to-obtain-prior-authorization-for-molecular-genomic-testing\/","title":{"rendered":"How to obtain Prior Authorization for Molecular Genomic Testing"},"content":{"rendered":"<p>Referring providers and laboratories may submit prior authorization requests or verify authorization status by contacting eviCore as follows:<\/p>\n<ul>\n<li><strong>Online by visiting<\/strong> eviCore\u2019s website at: <a href=\"http:\/\/www.evicore.com\" target=\"_blank\">www.evicore.com<\/a> and logging into the Provider login after completing a free registration. The site is available 24 hours a day, 7 days a week\u00a0and it is possible to obtain immediate authorization decisions if the coverage criteria are met.<\/li>\n<li><strong>Via telephone by calling<\/strong> eviCore toll free (888-693-3211), Monday through Friday from\u00a07a.m. to 7p.m. EST.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>For those cases that do not receive immediate authorization, eviCore\u2019s Certified Genetic Counselors will review and issue an authorization if the requested test meets the established evidence-based criteria. All other requests will be sent to an eviCore Medical Director for review and determination. All decision will be made within 2 business days for non-urgent requests once complete clinical information is received. All determination decisions will be sent in writing to the member, ordering provider, and laboratory if available. Urgent requests must be clinically warranted and submitted telephonically. When initiating the case, the caller must clearly sate that the request is \u201cUrgent\u201d.<\/p>\n<p>All adverse determination appeals related to the Prior Authorization of tests must be submitted by mail, fax or email to:<br \/>\neviCore Appeals Dept<br \/>\n400 Buckwalter Place Blvd,<br \/>\nBluffton, SC 29910<br \/>\nFax: 866-699-8128<\/p>\n<p>If you are unable to participate in a session, you can obtain a copy of the presentation as well as other important documents at <a href=\"https:\/\/www.evicore.com\/healthplan\/HNE_lab\" target=\"_blank\">https:\/\/www.evicore.com\/healthplan\/HNE_lab<\/a>.<\/p>\n<p>Documents are available in PDF format. If you need Adobe Reader, you can download it from <a href=\"http:\/\/www.adobe.com\/products\/reader\/\" target=\"_blank\">www.adobe.com\/products\/reader\/<\/a>. To receive important announcements and updates via email, please send your contact information to <a href=\"mailto:providernewsletter@evicore.com\" target=\"_blank\">providernewsletter@evicore.com<\/a>.<\/p>\n<p>If you have any questions regarding any of the included information, please contact Provider Relations at (800) 842-4464, ext 5000. A representative is available Monday \u2013 Friday 8am to 5pm, EST.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Referring providers and laboratories may submit prior authorization requests or verify authorization status by contacting eviCore as follows: Online by visiting eviCore\u2019s website at: www.evicore.com and logging into the Provider login after completing a free registration. The site is available 24 hours a day, 7 days a week\u00a0and it is possible to obtain immediate authorization [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3500,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[4],"tags":[],"class_list":["post-3496","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-informational-purposes-only"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2017\/07\/GettyImages-579162996-e1501521093999.jpg?fit=800%2C533","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-Uo","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/3496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=3496"}],"version-history":[{"count":4,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/3496\/revisions"}],"predecessor-version":[{"id":3502,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/3496\/revisions\/3502"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/3500"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=3496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=3496"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=3496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}