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News & Press: Insurance/Provider

eviCore Implementing NEW Therapy Authorization Model called corePath effective 1/26/2018

Wednesday, January 24, 2018   (3 Comments)
Posted by: Sheri Ryan
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eviCore healthcare's corePath® Model for

Physical, Occupational and Massage Therapies

Beginning January 26, 2018, Premera Blue Cross Blue Shield of Alaska in collaboration with eviCore will implement a new therapy authorization model called corePath which is geared to improve operational effectiveness. This model will streamline the authorization process and will be easier for the provider community to follow.

 

The corePath® model for Physical, Occupational and Massage therapies was designed to:

  • Reduce administrative burden on providers and their staff
  • Allocated therapy visits based on the severity of the member's condition and functional loss.
  • Allow providers with the ability to identify attributes that are unique to a specific member's condition.
  • Grant approvals for additional therapy visits with confirmation that a member's condition is progressing as expected.A more detailed review of a member's special needs is required for ongoing care.
  • Reduce the amount of clinical information required to request authorization
  • Integrate professionally accepted functional outcome measures, using validated measurement tools such as the Oswestry Disability Index and the Neck Disability Index
  • Allow providers to submit and receive authorizations in real time
  • Exclude preset maximums and waivers. Authorization decisions will be based on the member's condition and needs for all requests 

 

Unlike eviCore's previous process, authorizations will only apply to the initial course of treatment and additional therapy units will require a separate authorization.

 

eviCore is extending their online training sessions to ensure a better understanding of the therapy corePath® model beginning January 23 ,2018. During these sessions, eviCore will provide an overview of the corePath® system, forms and clinical pathway requirements for initial and follow-up requests.

 

A recording of the sessions will be posted on eviCore's implementation website and can be accessed by visiting https://www.evicore.com/healthplan/Premera for providers who can not attend.

 

Recording can be found here -->https://vimeo.com/252608026/2e43ad0589

 

Slidedeck from presentation -->Download PDF

 

 

If you are interested in registering for one of these informative training sessions, click the "Register Now" button below to be provided with session dates and instructions on how to register.

 

 

Comments...

Sheri Ryan says...
Posted Thursday, January 25, 2018
News article above UPDATED with Recording link and slidedeck download. Email UPDATE issued by Insurance Task Force Chair, Dr. Judd Wattenbarger to ACS Members with highlights from training and suggestions.
Sheri Ryan says...
Posted Thursday, January 25, 2018
Recording is NOW posted on https://www.evicore.com/healthplan/Premera. Scroll down to corePath RESOURCES Premera Therapy corePath Training Recording and Presentation. Here's the direct link https://vimeo.com/252608026/2e43ad0589 (copy and paste in a new browser window to access.)
Sheri Ryan says...
Posted Thursday, January 25, 2018
Powerpoint Presentation NOW AVAILABLE! ACS Members - check your email! We will send the webinar recording link as soon as it's received.

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