EviCore

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EviCore app streamlines medical necessity reviews and claims management for healthcare providers, improving efficiency and accuracy in patient care delivery.

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Empowering the Improvement of Care. EviCore by Evernorth (EviCore) offers proven, diversified medical benefits management solutions that help clients reduce costs while increasing the quality of care for their members. The company provides these solutions to managed care organizations and risk-bearing provider organizations serving commercial, Medicare, and Medicaid populations. Powered by a team of specialized medical professional resources, extensive evidence-based guidelines, and advanced technologies, EviCore supports clients by ensuring the right evidence-based care is delivered at the right time to the right patient at the right site of care. Flexible medical benefits management solutions are offered in: Radiology; Cardiology; Musculoskeletal; Medical Oncology; Radiation Therapy; Specialty Drug Management; Sleep; Lab Management; and Post-Acute Care. EviCore manages lives nationwide and is URAC-accredited and NCQA-certified.

EviCore provides a comprehensive platform designed to streamline medical necessity reviews and claims management for healthcare payers and providers. The app facilitates faster decision-making by leveraging advanced technologies such as near real-time document attachment and high-quality medical documentation creation, which can reduce review turnaround times by up to 50%. This enhances operational efficiency in processing prior authorizations and claims adjudication while maintaining accuracy and compliance.

Key features include an integrated workflow for medical necessity determination, supporting clinical data quality and enabling collaboration across the healthcare ecosystem. EviCore’s system helps reduce administrative burden by automating essential processes within the claims lifecycle, from pre-service authorizations to post-adjudication management. It is built to support the needs of health plans, providers, and business stakeholders by improving communication, documentation, and workflow transparency.

By connecting stakeholders and streamlining clinical and administrative workflows, EviCore contributes to reducing healthcare waste and expediting patient care delivery. Its platform supports agile implementation practices and integrates with enterprise project management tools to ensure timely delivery and adaptation to evolving healthcare requirements. Overall, EviCore is designed to enhance the efficiency, accuracy, and speed of healthcare claims and authorization processes through technology-driven solutions focused on medical necessity and patient-centered care.

This description was generated by AI (artificial intelligence). AI can make mistakes. Check important info.

Categories:

Medicine

Value-Based Performance Management Analytics Software

Website: evicore.com

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