Precertification/preapproval by CareCore National, LLC d/b/a eviCore healthcare (eviCore) for certain radiation therapy services



    The Company requires precertification/preapproval through CareCore National, LLC d/b/a eviCore healthcare (eviCore) to manage requests for select outpatient, non-emergent radiation therapy services for members enrolled in its Medicare Advantage HMO and PPO products using the eviCoreRadiation Therapy Clinical Guidelines* to determine medical necessity. For more information about the radiation therapy services that require precertification/preapproval, refer to the current version of medical policy #MA09.020: Radiation Therapy Services.

    * eviCore utilizes multiple sources to develop their Radiation Therapy Clinical Guidelines, including consultation with the Company, evidence-based guidelines and recommendations from national and international medical societies, and evidence-based medicine research centers, including, but not limited to, American Society of Radiation Oncology [ASTRO], National Comprehensive Cancer Network [NCCN], and American College of Radiology [ACR].

    To access Independence’s version of the eviCore Radiation Therapy Clinical Guidelines, click here andscroll down to select the criteria that are specific to Independence.

    Issued on - 02/17/2015


Connect with Us        


2017 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.