Advanced Imaging And Cardiology Services Program
Last Updated: Thursday, October 26, 2023
Highmark has partnered with eviCore healthcare (eviCore) for the Advanced Imaging and Cardiology Services Program. This program incorporates a comprehensive, evidence-based clinical review including predictive intelligence, clinical decision support, and peer-to-peer discussions.
eviCore will manage the prior authorizations for advanced imaging and
cardiology services for Highmark's fully insured Commercial, Children's Health Insurance Program (CHIP) of Pennsylvania, Medicare Advantage, and Affordable Care Act (ACA) members, plus members of select self-insured (Administrative Services Only) groups.
Effective August 1, 2021, the program will expand to include out-of-area (OOA) and out-of-network (OON) cardiology and radiology services.
Note: The Federal Employee Program is excluded from this program.
Learn More About the Advanced Imaging and Cardiology Services Program
eviCore has a dedicated webpage for Highmark providers to convenientlyaccess evidence-based clinical guidelines, the current CPT code list, important resources and recent announcements. We encourage you to visit their site to ensure that you have the most current information.
You can also find any updates about the Advanced Imaging and Cardiology Services Program in the provider portal(s) and future issues of Provider News
eviCore healthcare is an independent company that does not provide Highmark products or services and is solely responsible for the products and services described here.
