No authorization required for BCN initial PT, OT and ST evaluations

Here's some information you need to know about submitting requests to eviCore healthcare for physical, occupational and speech therapy and physical medicine services by chiropractors:

• BCN no longer requires authorization for initial evaluations.
• The initial evaluation should be completed before you request authorization for treatment. If you submit the request before the evaluation, you may not be able to complete all of the required questions in the pathway, which could result in your request being pended.

Who should submit the authorization request

We recommend that the practitioner who will perform the therapy or physical medicine treatment services submit the request to authorize treatment. This is because it is that practitioner who is most familiar with the patient's condition and who can most readily answer the questions posed within the eviCore provider portal.

Additional information

Refer to the document Outpatient rehabilitation services: Frequently asked questions for additional information.

We're also updating the information in the Care Management chapter of the BCN Provider Manual to reflect the recent changes in how eviCore accepts authorization requests starting May 27, 2019.

Posted: June 2019
Line of business: Blue Care Network