endobj Refer to the March 30, 2023, provider notice (PDF) for more information and to register for training based on your physicians specialty. Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization. $4d? vI Portal Login Insights Blog eviCore Colorectal Screening Program Prior authorization status can be viewed on demand via the eviCore portal at www.evicore.com or by calling eviCore at 866-220-3071. Availity Essentials, Essentials Plus, or EDI Clearinghouse Customers: If you have an Availity Essentials, Essentials Plus, or EDI Clearinghouse account and cannot log in to submit a ticket, call 1-800-282-4548 for support. Positron emission tomography computed tomography (PET-CT), Computed tomography angiography (CTA) scans, Non-OB ultrasound including head & neck, pediatric, breast, abdomen & retroperitoneum, extremity, arterial & venous, and gynecological, OB ultrasound including obstetrical ultrasounds and fetal echocardiography, eviCore currently maintains a nationwide advanced imaging network, featuring contracts with providers of imaging services in specific/predetermined locations. Provider costs are reduced and decisions are communicated in real time, reducing delays. of authorization request(s). . Manage practice information, access staff training and complete attestation requirements. In keeping with DFS guidance, MetroPlusHealth's UM protocols resumed on June 22, 2020, including resuming issuing Prior Approvals and performing concurrent review. Their sole job is to ensure patients get the best possible care. of authorization request(s). wont be able to apply to eviCore openings. we will be implementing changes to evicore.com in the near future. its a guideline to help us practice medicine better, and to keep safety in mind for our patients by not over utilizing explains Dr. Robert Good, VP & Associate Chief Medical Officer for Carle Health, on how eviCores solutions have made a difference for their patients in the newest Auth the Cuff podcast. All Rights Reserved. Another part is having access to an exceptionally large volume of historical cases. Call Customer Service at 888-850-8526, 8 a.m. to 8 p.m., Monday through Sunday. External link You are leaving this website/app (site). For more information about prior authorization, please review Mercy Care's Provider Manuals located under the Provider Information tab on our website. %PDF-1.6 % You might find that the answer is simpler than you think! Report Fraud & Abuse | Electronic Data Interchange (EDI) Email: EDI@premera.com To viewrequirements summaries andprocedure code lists, refer to theSupport Materials (Commercial)andSupport Materials (Government Programs)pages. Q1: Overall, how satisfied are you with eviCores website? Claims UnitedHealthcare Community Plan Quest Integration P.O.Box 31365 Salt Lake City, UT 84131-0365 Payer ID#: 87726 (EDI Claims Submission) Claims Optum P.O. Annual Utilization Statistics | (This information should not be relied on as authorization for health care services and is not a guarantee of payment.). Second, when requests reach a final status, the patient receives a letter indicating whether the request has been approved or denied. Q4: How can eviCore make it easier for you to use this website? Report concerns to the BCBSIL Special Investigations Department (SID) Fraud website 1 . endobj Create an Account. Listen to our latest podcast episode with new host, Dr. Emily Coe featuring Dr. Mayank Shah. stream View fee schedules, policies, and guidelines. eviCore positions. Musculoskeletal (eviCore): 800-540-2406 Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number, which can be found here. Please click here to register for an account. Report Fraud & Abuse | Most PDF readers are a free download. Copyright 2022 eviCore healthcare. Based on the feedback we receive, we continuously upgrade our operational efficiencies through ongoing addition of Web enhancements that improve the user experience and offeradditional support to our providers. Eligibility Verification Providers should verify member eligibility prior to requesting/providing services. <>>> *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * Tune into our new podcast episode with eviCore's medical oncologists Dr. McLead, Associate Medical Director, and Dr. Gaskins, Sr. Medical Director, for an informative conversation on clinical trials, disparities in medical oncology, and how eviCore is aiming to bridge the gap with the most recent evidence-based options for oncology patients. It speaks to the rapidly evolving healthcare industry, especially the increasing role of prior authorization and how providers can more effectively navigate it. Reminding and guiding patients to get the care they need. Use theAvailityProvider Portalor your preferred vendor to check eligibility and benefits before rendering services. The process for starting a new prior authorization depends on the health plan and solution that you are submitting the new prior authorization for. open positions so continue your job search at Cigna.com/careers, Were on a quest to improve the experience of administrators, clinicians, and patients who work with us. Why is eviCore providing intelliPath ePA free of charge for eviCore-managed lives? As a valued user of our website, wed appreciate your feedback to help us improve your website experience. Prior authorization requests for our Blue Cross Medicare Advantage (PPO)SM(MA PPO), Blue Cross Community Health PlansSM(BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SMmembers can be submitted to eviCore in two ways. Our host Emily Coe, PhD, speaks with Alegis Care social worker Katie Sherman, MSW, LCSW, to learn more about home health, social determinants of health, access to care, and more. of authorization request(s). 400 Buckwalter Place Blvd. % Terms of Use | Our network of quality providers offers an attractive option for health plansseeking to more appropriately manage radiology benefits. Telehealth, Telemedicine Hologram Care? Prior authorization is required by Carelon Medical Benefits Management (formerly AIM . We would like to help. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company. Do you offer a mandatory prior authorization program for all sleep studies? Or you can call Provider Services at . The reality is, most providers weren't initially trained to deliver virtual care. Certain employer groups may require prior authorization or pre-notification through other vendors. In addition, peer-reviewed literature, major treatises, input from health plans, and practicing academic and community-based physicians are also utilized in the construction of our guidelines. In order to determine the appropriate portal to use to submit your prior authorization, we have made it easy for you. \u003ca href=\"https://content.highmarkprc.com/Files/NewsletterNotices/SpecialBulletins/sb-post-phe-provider-communication.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"\u003e\u003cstrong\u003eCLICK HERE\u003c/strong\u003e \u003c/a\u003efor the details.\u003c/p\u003e","visible":false,"archive":false,"liveStatus":2}], Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (, Examples of services that may require authorization include, Potentially experimental, investigational, or cosmetic services, Select injectable drugs covered under the member's medical plan, Select Not Otherwise Classified (NOC) procedure codes, i.e., unlisted, miscellaneous, Not Otherwise Specified (NOS). As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, Emergency room visits don't require prior authorization. Benefits > CHS Group Information" or call the prior authorization phone number on back of the member's ID card. As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, eviCore made it easy to complete my primary task online. All Rights Reserved. Member Rights Policy | All Rights Reserved. 3 0 obj If the requested exam is denied, eviCore will notify both you and your physician and provide you with detailed appeal instructions. Submit requests via fax to 1-888-693-3210 Monday through Friday between 8 a.m. and 9 p.m. EST. Tune into our recent podcast episode with eviCore's post-CAM program specialists Dr. Chanta Van Laanen, Dr. Laura Beitz-Walters and Dr. Mark Leichter to learn more. open positions so continue your job search at Cigna.com/careers, Something went wrong.Please try again after some time, Thank you for submitting. GEHA, like other federal medical plans, requires providers to obtain authorization before some services and procedures are performed. Annual Utilization Statistics | 1 0 obj How does eviCore interact with providers? Visit www.evicore.com Call 800.533.1206 Monday - Friday: 7:00 a.m. to 7:00 p.m. *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * Our hosts Dr. Torelli and Liz Avila are here to explain why. eviCore positions. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. What additional tools are available as add-on programs to the Cardiovascular solution? The site may also contain non-Medicare related information. eviCore currently maintains a nationwide advanced imaging network, featuring contracts with providers of imaging services in specific/predetermined locationsand as well as freestanding facilities. eviCore positions. Please use the BCBSAZ MA prior authorization fax form or the eviCore online request tool, available on the secure MA . What is included in the Radiation Oncology program? For prior authorization requests handled by BCBSIL: There are two ways to initiate your request. In addition to verifying membership/coverage status and other important details,this step returns information on prior authorization requirements and utilization management vendors, if applicable. Effective dates are subject to change. The Member Customer Care Center is open Monday-Friday, 8 am to 6 pm (ET). What types of cardiovascular procedures require prior authorization? Note: Checking eligibility and benefits is key, butwe also have other resources to help you prepare. %%EOF <> Moving forward, please visit CoverMyMeds or via SureScripts in your EHR to learn more and submit all new PA requests electronically. Why do we recommend conservative treatment options first? Additional information about the programs and links to prior authorization codes are available under Care Management Programs in the left website menu. eviCore fax number: (800) 540-2406 Web Portal Services-Assistance 4 Web Support Phone: 800-646-0418 (Option 2) Email: portal.support@evicore.com Web Portal Services-Available 24/7 Pre-Certification Call Center Web-Based Services Client Provider Operations Documents Client Provider Operations Pre-Certification Call Center Download a form from the Forms & Resources section of the Evicore website and fax it to 1-888-693-3210. For quick reference, see the GEHA member's ID card. How do I know when my test has been authorized? MCG Clinical Criteria- Information on Highmark's incorporation of MCG Health evidence-based clinical guidelines into Highmarks criteria of clinical decision support. PROVIDERS AREA. How does my doctor access the Specialty Drug Management solution? Always check eligibility and benefits first,via theAvailityEssentialsor your preferred web vendor, prior to rendering care and services. You can verify benefits and request prior authorization at Availity.com or by phone at 1-888-693-3211 1-888-693-3211. Eligibility and benefits can be verified by accessing NaviNet or by calling the number on the back of the members identification card. Call 1 (800) 88CIGNA (882-4462). information about accessing the eviCore portal. Member Rights Policy | All Rights Reserved. The associated preauthorization forms can be found, Gastric Surgery/Therapy/Durable Medical Equipment/Outpatient Procedures: 888-236-6321, Home Health/Home Infusion Therapy/Hospice: 888-567-5703, WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC.,for, View the List of Procedures/DME Requiring Authorization, View the List of FEP Standard and Basic Procedures/DME Requiring Prior Approval, View the List of FEP Blue Focus Procedures/DME Requiring Prior Approval, Non-Urgent Inpatient Authorization Submission, Urgent Inpatient Authorization Submission, Auth Automation Hub Frequently Asked Questions, Advanced Imaging and Cardiology Services Program, Musculoskeletal Surgery and Interventional Pain Management Services Prior Authorization Program, Post-Acute Care for Medicare Advantage members, Inpatient admissions (e.g., acute inpatient, skilled nursing facility, rehabilitation hospital, behavioral health facility, long-term acute care facility), Speech Therapy services, including those provided to Medicare Advantage members. IMPORTANT: In the coming days, we will be migrating systems for our For many services, we manage the precertification process directly. PDF File is in portable document format (PDF). Authorization number not appearing, unable to locate member, questions about clinical criteria screen. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. reCAPTCHA is not valid; Please try again! You can request an expedited appeal by calling the prior authorization number for the plan that covers your patient. Lab Prior Authorization CPT Code List. <> eviCore made it easy to complete my primary task online. Service preapproval is based on the members benefit plan/eligibility at the time the service is reviewed/approved. To request any additional assistance in accessing the guidelines, . As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. Thank you for using eviCores website today! Usually, the provider is responsible for requesting prior authorization before performing a service if the member is seeing an in-network provider. Specialized therapies such as chiropractic, acupuncture, and physical therapy are cost effective, and can provide improved outcomes for chronic pain patients. Listen to the new Auth the Cuff podcast for more information. eviCores evidence-based Radiology Clinical guidelines are based upon major national and international association and society guidelines and criteria. Prior authorization lookup tool. Please join us in reflecting back on the best moments from Auth the Cuff in 2020. endobj Watch the latest Auth the Cuff podcast featuring Dr. Sid Govindan and John Young. ", Chief of Radiology & SVP of Medical Affairs. Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status of authorization request (s). Most PDF readers are a free download. [{"id":39210,"versionId":6468,"title":"Highmark Post-PHE Changes","type":4,"subType":null,"childSubType":"","date":"4/7/2023","endDate":null,"additionalDate":null,"imageUrl":null,"url":null,"urlText":null,"description":"\u003cp\u003eWith the upcoming expiration of the PHE, Highmark has started the process of updating COVID-19-impacted policies and procedures. Online - The eviCore Web Portal is available 24x7. Preauthorization Lists New Empire Precertification Requ . EmblemHealth Reduces Preauthoriz . Beginning Friday, December 18th at 5:00pm EST, you Q4: How can eviCore make it easier for you to use this website? Which EHRs does eviCores intelliPath ePA support? Highmark requires authorization of certain services, procedures, and/or Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) prior to performing the procedure or service. Our goal is to provide high-quality, cost-effective sleep management services to customers who are covered under benefit plans that include precertification of outpatient procedures. Member Rights Policy | Prior authorization requests for our Blue Cross Medicare Advantage (PPO) SM (MA PPO), Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. All Prior Authorizations can be submitted online, except the following: Must besubmitted via the appropriate fax line or by phone at 1-888-FIDELIS (1-888-343-3547): Urgent Requests o Initial Inpatient Rehabilitation can now be submitted online via provider portal o Inpatient Emergency Room Admission Requests Concurrent Requests By presenting lower-cost, convenient, and high-quality options, SmartChoice empowers members to make more informed comparisons and choices. Medical Oncology: Call: 1 (866) 668-9250 Fax: 1 (800) 540-2406. Services requiring prior authorization through eviCore are outlined below. reCAPTCHA is not valid; Please try again! Continue to Authorization Lookup Login Log In Forgot User ID? BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. Some requests are handled by BCBSIL; others are handled by utilization management vendors. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. There are three ways to submit requests to eviCore healthcare for outpatient diagnostic imaging procedures: Contact them via phone at 1-888-693-3211 Monday through Friday between 8 a.m. and 9 p.m. EST. %PDF-1.5 The list indicates which CPT codes require preauthorization based on site of service and diagnosis codes. Call Center: eviCore's is available from 7 a.m. to 7 p.m. Meet Dr. Scarborough, Chief of Radiology & SVP of Medical Affairs. The site may also contain non-Medicare related information. Providers and/or staff can request prior authorization and make revisions to existing cases by calling 1-866-496-6200. If you are a Highmark network provider and have not signed up for NaviNet, learn how to do sohere. Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status Copyright 2022 eviCore healthcare. The instructions on how to submit a case and a link to the correct portal to use will be provided. By presenting lower-cost, convenient, and high-quality options, SmartChoice empowers members to make more informed comparisons and choices. As a valued user of our website, we'd appreciate your feedback to help us improve your website experience. Refer to the Procedures that require authorization by eviCore healthcaredocument for more details. Apr 06, 2023. eviCore positions. Online forms from eviCore's carriers hub MENU PROVIDERS About; Solutions. Register Now Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. To view this file, you may need to install a PDF reader program. Box 30757 Salt Lake City, UT 84130-0757 Payer ID#: 87726 (EDI claims submission) Pharmacy 560 0 obj <>/Filter/FlateDecode/ID[<8C57985C8CBDD144A535DF79903CF9DC>]/Index[539 33]/Info 538 0 R/Length 105/Prev 288900/Root 540 0 R/Size 572/Type/XRef/W[1 3 1]>>stream For additional resources on the Helion Arc authorization process, includinginstructionalvideos,CLICK HERE. GHI Medicare non-City of New York. Some authorization requirements vary by member contract. Request a Consultation with a Clinical Peer Reviewer, Check Status Of Existing Prior Authorization, Digital Breast Tomosynthesis is a Hot Topic, Global Shortage of Iodinated Contrast Media, Q&A: eviCores Chief of Radiology on the Need for Evidence-Based Imaging, The 8 Most Common Inappropriately Ordered Tests and Why They're Being Denied, Check Status of Existing Prior Authorization. . 410 N. 44th Street, Suite 900. jandbmedical.com. Were still hiring for other Register Now Please check directly with your health plan for specific requirements or contact eviCores Customer Service at (800) 918-8924. You'll find more information on authorizations in the GEHA plan brochure. Trials, Treatments, and Oncology Breakthroughs, Check Status of Existing Prior Authorization. Contact us Chat with us now. How do I know when my test has been authorized? What can chiropractic services do for my lower back pain? For government programs prior authorization requests handled by eviCore healthcare (eviCore): *, Q2: Choose the primary task you came to the website to complete:*, Q3: Please rate the following statement: * open positions so continue your job search at Cigna.com/careers. 5 0 obj Were still hiring for other To contact Customer Care, please call the phone number on the back of your Member ID Card. Member Rights Policy | The process for starting a new prior authorization depends on the health plan and solution that you are submitting the new prior authorization for. eviCore made it easy to complete my primary task online. Ethics & Compliance | . Beginning on 3/15/21, web users will be required to log in to evicore.com in order to check the status E-Verify and IER Right to Work. xUn@}?SeGbWZ"%@T%!RUE}\ZCRPC }X9sf8;;wngs!%`%9y+tVpz``j&[gc; L5uL"C|@8%*i0NeeFETPr$s@?(fXf,bj)z] p)c3+$Ht^NJ)('z#jc'C&9.BaE7K\ed:2\ueD(AqupHO([itZqIuX.UvV,VW7q|U}[dEMz@T`xbSg:qbL}yb Al55&9)T9^6'PZ'CGjtt Tk[&nX^\C`=?EAy5z-WWVx/)p=]l8N/q%KDs!wfk!P! What additional tools are available as add-on programs to the Radiology solution? <> If you donotget prior approval via the prior authorization process for services and drugs on our prior authorization lists: When and how should prior authorization requests be submitted? What is included in the Cardiovascular solution? eviCore will communicate the determination utilizing the following methods: open positions so continue your job search at Cigna.com/careers. Introducing eviCores new podcast Auth the Cuff! Q1: Overall, how satisfied are you with eviCores website? "eviCore has over 1,100 doctors, therapists and nurses from a variety of specialties. Dr. Torelli and Liz Avila are back today discussing the growing issue of rising healthcare costs. Well before the pandemic, consumers were leaning towards home healthcare versus facility based care when appropriate for a number of reasons. They are discussing how recent technology innovations will be utilized to better partner with providers as we work to redefine healthcare and drive value to patients. Fax the request form to 888.647.6152. Register Now eviCore intelliPath . Note: Most out-of-network services require utilization management review. of authorization request(s). This new site may be offered by a vendor or an independent third party. How will my doctor know where I am going? 2 0 obj Clinical guidelines are becoming increasingly necessary to get proper testing, but not all guidelines are created equal. In this weeks podcast, Dr. Torelli and Liz Avila discuss why its important for all patients to learn more about their care. Our newly redesigned provider solutions help reduce the complexities and costs involved in securing prior authorization(PA) for medical procedures and tests. Outpatient: 1-844-442-8012. This information is intended to serve as a reference summary that outlines where information about Highmarks authorization requirements can be found. Learn more from eviCore experts Sid Govindan, MD and John Young on how eviCore is applying these technologies to evolve the prior authorization process. Click herefor the MFA registration & setup guide. We offer providers ongoing touch-pointsthat include a team dedicated to on-site visits; professional surveys; and the rigorous tracking and receiving of feedback from both providers and our clients. wont be able to apply to eviCore openings. The system can easily be made an extension of the clients existing claims workflow. Q1: Overall, how satisfied are you with eviCores website? You may also go directly to eviCore's self-service web portal at www.evicore.com. Q4: How can eviCore make it easier for you to use this website? If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments. 4 0 obj IMPORTANT: In the coming days, we will be migrating systems for our All Rights Reserved. Emergency services are an exception. Simply, notify HAP within 48 hours of the emergency admission. Pre-authorization Electronic authorizations Use Availity's electronic authorization tool to quickly see if a pre-authorization is required for a medical service or submit your medical pre-authorization request. wont be able to apply to eviCore openings. Beginning Friday, December 18th at 5:00pm EST, you Please complete the Dental Specialty Referral Request Form and fax to 480-350-2217, email to: HCHdentaldeptHCA@azblue.com, or mail to: BCBSAZ Health Choice, Inc. Attn: Dental Prior Authorization. As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, Emily Coe, PhD interviews eviCore's Dr. Mary Kay Barton, Sr. Medical Director, Medical Oncology, and Dr. Gary Jones, Associate Medical Director, Medical Oncology, for an enlightening conversation on clinical trials in pediatric and adult oncology, treatment innovations, and more. What types of radiology procedures require prior authorization? If you have any questions, call the number on the member's ID card. If you need preauthorization, contact eviCore in one of three ways: Get immediate approval by submitting your request at www.evicore.com. Review claim status and request claim adjustments. Copyright 2022 eviCore healthcare. Subject: Sign- up for eviCore Healthcare's Training for new Prior Authorization requirements! Provider Education -We interact with providers during implementation and on an ongoing basis to render support and educational resources, as well as obtain feedback for solution improvements. reCAPTCHA is not valid; Please try again! The list applies to the following EmblemHealth lines of business: GHI Commercial non-City of New York. What is included in the Radiology solution? How does a computer make healthcare decisions? For precertification, go online to eviCore.com or use the contact information below. Member Rights Policy | If you have questions on a request handled by BCBSIL, contact our Medical Management department. IMPORTANT: In the coming days, we will be migrating systems for our 1-800-972-8382. Call 1-888-233-8158 from 8:00 a.m. to 9:00 p.m., Eastern, Monday through Friday. eviCores new electronic prior authorization eviCore intelliPath is already being deployed inside the existing prior authorization workflow and by provider organizations to automate and simplify the process of submitting and tracking requests for prior authorization. Please click here to register for an account. Where are Musculoskeletal Program guidelines and how are they accessed? Review claim status and request claim adjustments. eviCore is committed to providing an evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics, and sensitivity to the needs of everyone involved across the healthcare continuum. As part of our continued effort to provide a high quality user experience while also ensuring the integrity of the information of those that we service is protected, Manage practice information, access staff training and complete attestation requirements. eviCore intelliPath streamlines operations within a single easy-to-use application that integrates with major EHRs. Continue to Authorization Lookup Login Log In Forgot User ID? eviCore healthcare (eviCore) Obtain benefit preauthorization for certain care categories. eviCore intelliPath reflects eviCores commitment to modernize prior authorization and remove barriers to evidence-based care. Intake form. Check Status of Existing Prior Authorization. Member Rights Policy | eviCores Radiology solution delivers cost savings and improved patient outcomes by ensuring health plan members receive the appropriate test or treatment necessary for their individual case presentation or condition. Copyright 2022 eviCore healthcare. Effective May 1, 2023, AmeriHealth Caritas North Carolina (ACNC) will require prior authorization via eviCore healthcare for selected health care services. First, our innovative SmartChoiceprogram serves as a patient-outreach service to educate health plan members on available options for their diagnostic imaging procedure locations. The site may also contain non-Medicare related information. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. Phone Number 1.800.646.0418 x20136 Email portal.support@evicore.com Affiliations Stay Updated With Our Provider Newsletter Your email address Website Feedback Thank you for using eviCore's website today! Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Behavioral Health IP PA - IVR Caller Guide, Behavioral Health OP PA - IVR Caller Guide, Inpatient Preauthorization - IVR Caller Guide, Outpatient Preauthorization - IVR Caller Guide, Preauthorization: Check Request Status - IVR Caller Guide, Utilization Management Process Overview (Commercial), Patients medical or behavioral health condition, Date of service, estimated length of stay (if the patient is being admitted), Provider name, address and National Provider Identifier (NPI), Government Programs 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI).