• Utilization management
• Appeals
• Claims processing and payment for certain radiology services
• Assessment and privileging non-radiologists in the tri-state area (NY, NJ, and CT)

• This program educates individuals undergoing an MRI, CT, or PET scan about their options for geographically convenient and cost-effective facilities, as they and their doctors choose where to have the scans done.
• eviCore assists with scheduling appointments.
• eviCore does not place calls in urgent or emergency situations, or when the choice of another facility is not available due to clinical circumstances or patient needs.

• CT/CTA
• MRI/MRA
• PET
• Nuclear cardiology imaging
• Stress echocardiogram
• Diagnostic left and right heart catheterization

• Inpatient
• In an emergency room
• During a 23-hour observation

• You can generally determine if your patient's plan requires precertification for these services by looking for “Outpatient Procedures” on the back of their Cigna ID card.
• It is the responsibility of the performing facility to confirm that the referring physician completed the precertification process for advanced imaging procedures.
• Verification may be obtained through our website at evicore.com or by calling 888.693.3297.

• Through the precertification process, eviCore helps ensure that patients receive tests and treatments that improve diagnoses and follow established coverage guidelines.
• By reducing duplicative tests and limiting unnecessary radiation exposure, our program improves the quality and safety of care, while facilitating earlier treatment that is more appropriate.
• eviCore's unique education approach includes the only “predictive intelligence” technology in the industry, which provides nearly instant precertification approval in areas where a physician consistently practices within our evidence-based guidelines.
• eviCore educates customers about options for cost-effective treatment at certain facilities (through Informed Choice).
• All Cigna-participating providers in eviCore's network are credentialed and reviewed for quality.

Dedicated support

We're there for you when you need us. Online or on the phone.

Precertification:

• Website: evicore.com
• Phone: 888.693.3297 (8:00 am–7:00 pm EST)
• Fax: 888.693.3210

eviCore's radiology coverage guidelines:

• evicore.com/cignaguidelines

Market implementations and announcements:

• evicore.com/Cigna

Clinical support through Radiology AnswerLine®:

eviCore welcomes requests for clinical discussions from referring physicians and radiologists.

• To request a clinical discussion, call 888.693.3211 and choose option four.

Cigna customer service:

• 800.882.Cigna (800.882.4462)

eviCore portal support:

• Website: evicore.com. Once logged in to the portal, click the “Online Chat” button located in the upper right hand corner of the page.
• Phone: 800.575.4594 (8:00 am–7:00 pm EST)
• Email: portal.support@evicore.com

Customer benefit inquiries and eligibility:

• CignaforHCP.com

Claims

• Cigna-contracted providers should submit claims directly to Cigna at the address on the back of the customer's ID card
• Claim status inquiries: CignaforHCP.com
• eviCore contracted providers must submit claims directly to eviCore:*
• Claims can be submitted by:
  
  

  Electronically:	Claim ID: 62160
  By mail:	eviCore healthcare PO Box 981612 El Paso, TX 79998

• Claim status inquiries: evicore.com

*Exceptions to this include claims where Cigna is secondary to Medicare, or when the claim is for a patient who is part of the Starbridge Beech Street primary network. In these cases, claims should be submitted to Cigna. All other providers should continue to submit claims directly to Cigna at the address on the back of the patient's ID card.