Blue Cross Complete is pleased to announce their collaboration with eviCore healthcare to provide prior authorization management services for Blue Cross Complete members. eviCore, an Evernorth Health Services business, is a specialty medical benefits management company that collaborates with health plans to provide utilization management services.

Effective May 1, 2023, Blue Cross Complete will require prior authorization from eviCore for the covered health care services listed below. Services performed in conjunction with an inpatient stay, 23-hour observation, or emergency room visit are not subject to prior authorization requirements:

• Physical Therapy
• Genetic Testing
• Occupational Therapy
• Joint & Spine Surgery
• Pain Management
• Diagnostic Sleep Testing

Services performed without following prior authorization requirements may not be reimbursed, and you may not seek reimbursement from Blue Cross Complete the member.

Click here to read the full announcement and to learn how to request prior authorization.