Our Enhanced Clinical Review Program will begin January 1, 2019. The program requires authorization for certain procedures and will be administered by CareCore National doing business as eviCore healthcare. It will affect Western New York members in our commercial and Medicare Advantage HMO/PPO Aetna-branded products. Below are the services that will and will not require preapproval under this program.
Services that will require preapproval
For a complete list of procedures requiring an authorization, visit eviCore healthcare.
Services that will not require preapproval
How to request prior authorizations
– 1-800-540-2406 (radiology)
– 1-888-444-1562 (cardiology)
– 1-888-511-0403 or 866-999-3510 (sleep studies)
Have questions or need information?
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