Providers are required to obtain precertification through CareCore National, LLC d/b/a eviCore healthcare (eviCore) for non-emergent outpatient radiation therapy services for all commercial and Medicare Advantage HMO, POS, and PPO members. We use eviCore Radiation Therapy Utilization Management Criteria when reviewing requests for radiation therapy services. For members younger than 19, services requested will be automatically approved; however, precertification through eviCore is still required to ensure accurate and timely claims payment.
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