New Prior Authorization Requirements through eviCore

Molina Healthcare of Michigan (Molina) has contracted with eviCore healthcare (eviCore), an independent specialty medical benefits management company, to provide outpatient utilization management services. The new program is designed to streamline the authorization process through on-line and/or phone requests.

eviCore will manage prior authorization requests for the following specialized clinical services, effective for dates of service on or after October 1, 2019:

  • Imaging and Special Tests
    • Advanced Imaging (MRI, CT, PET, Select Ultrasounds)
    • Cardiac Imaging
  • Radiation Therapy
  • Sleep Covered Services and Related Equipment
  • Genetic Counseling and Testing

Molina and eviCore will be providing online web orientation sessions designed to assist your office staff with how to submit prior authorizations to eviCore, identify impacted services and codes, and navigate the eviCore website and provider portal. We encourage your office staff to attend these informative sessions to ensure your understanding of the new prior authorization process.

Web Orientation Sessions

Anyone wishing to attend one of the online web orientation sessions must register in advance. Each online web orientation session is free of charge and will last approximately one hour.

How to Register

Please read the following instructions carefully to register for and participate in a session:

  1. Once you have chosen a date and time, please go to https://evicore.webex.com/
  2. Click on the “Training” tab at the top of the Web page
  3. Click the “Upcoming” tab and find the date/time of the conference you wish to attend. All of the Provider Orientation Sessions will be named based on the specialty, e.g. “Molina MI Imaging and Special Tests Provider Orientation.”
  4. Click “Register” next to the session and enter the registration information.

After you have registered for a session, you will receive an e-mail containing the toll-free phone number and meeting number, conference password, and a link to the web portion of the conference. Please keep the registration e-mail so you will have the link to the web conference and the call-in number for the session in which you will be participating.

If you are unable to participate in a session at any of the times listed, you can obtain a copy of the presentation as well as other important documents at https://www.evicore.com/resources/healthplan/molina. Documents are available in PDF format. If you need Adobe Reader, you can download it at www.adobe.com/products/reader/.

We hope you find the following times convenient. All session times are listed in Central and Eastern Time.

Molina MI Imaging and Special Tests Provider Orientation

Molina MI Radiation Therapy Provider Orientation

Molina MI Genetic Counseling and Testing Provider Orientation

Molina MI Sleep Covered Services and Related Equipment Provider Orientation

Providers who have questions, concerns or would like additional information about eviCore may contact Provider Services at MHMProviderServicesMailbox@MolinaHealthCare.Com

Leave a Reply