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Priority Health - New Authorization Company and Process

June 1, 2017

New authorizations and our partnership with eviCore will launch on June 19, 2017.

The partnership with eviCore  will optimize health outcomes through a focus on clinical appropriateness includes new authorizations for the following services:

  • All musculoskeletal procedures, such as surgeries or arthroscopies for hips, knees and shoulders
  • Spinal procedures, including open, percutaneous and endoscopic interventions, like fusions and laminectomies
  • Genetic testing
  • Advanced diagnostic imaging authorization will move from AIM to eviCore

Find a complete list of CPT codes that will require prior authorization along with FAQs and more at evicore.com/healthplan/priorityhealth

Training webinars are also available, and eviCore will schedule additional sessions as we get closer to the launch.

June 1     Thursday            1:00 PM Eastern                          Spine and Joint

June 1     Thursday             9:00 AM Eastern                         Radiology

June 1     Thursday            11:00 AM Eastern                        Lab Services

Details on how to register for the webinars is available at evicore.com/healthplan/priorityhealth and then click on the “Priority Health Web Orientation Invitation.”

How to request authorizations starting June 19

You’ll work directly with eviCore to request authorizations through one of the following options (note: you cannot request authorizations prior to the go-live date of June 19):

  • Online: Log in to Priority Health provider account and click Auth Request in the provider tools menu
  • Phone: Call eviCore direct at 844.303.8456
  • Fax radiology/spine/joint auth requests: 800.540.2406; lab: 844.545.9213