Reminder: Register For Evolent Oncology Prior Authorization Training

With the May 1 launch of the Evolent oncology authorization program fast approaching, we encourage oncology providers to attend an upcoming training session.

As previously communicated, Highmark is engaging Evolent to manage prior authorization requests for medical and radiation oncology for some Highmark members. This collaboration is a key part of our oncology value-based care strategy, designed to improve clinical outcomes and streamline the authorization process.

Prepare for the Go-Live: Register for Training

To ensure you are fully prepared and understand the new processes, Evolent is hosting live, virtual training sessions. These sessions will provide comprehensive information about the program and guide you through the authorization process.

You can find dates, registration links, and additional resources on the Evolent resource page.

What This Means for You

• Effective May 1, 2026, additional codes related to medical and radiation oncology, as well as other specialty drugs, will be added to the prior authorization list. Much of this is to reflect the multi-drug regimens that are the standard of care in oncology and part of Evolent’s review process.
• You will continue to submit oncology authorization requests through Highmark's provider portal, Availity Essentials.
• For requests requiring review, supporting clinical documentation will be uploaded directly to the Evolent CarePro portal.
• Evolent's high-touch model offers several benefits, including dedicated support, real-time approvals for evidence-based treatments, and peer-to-peer discussions with oncology physician reviewers.

Questions?

If you have any questions regarding Evolent programs or the upcoming changes, please email providertraining@evolent.com.