Why do I have to use eviti|Connect to obtain preauthorization?
Your patient's insurance company requires the use of eviti|Connect in order to:
- offer physicians access to evidence-based cancer treatment guidelines, through our web-based program called eviti|Advisor.
- allow the provider office staff to receive automated preauthorizations for chemotherapy and radiation treatment plans through our web-based program called eviti|Connect.
I need a preauthorization for chemotherapy or radiation for a patient. What do I do?
- Open an Internet web browser
- Navigate to connect.eviti.com
- If you are not already a registered eviti|Connect user, you will need to register yourself.
- Once you are logged into eviti|Connect, you can print out a Chemotherapy or Radiation Checklist from the main page to assist you in collecting the clinical data needed.
- Enter the patient's information & treatment plan. Since eviti reviews treatment plans based on their compliance with standards of care and with evidence-based medicine, it is important to enter a complete oncology treatment plan.
Do I need a preauthorization from eviti|Connect every time the patient comes to the facility for a treatment?
No, but you need to submit all parts of the patient’s chemotherapy (including anti-cancer drugs and supportive drugs) or radiation treatment plan (including target site, delivery method, etc.), at the time the treatment is ordered by the physician and before the patient begins receiving treatment. For additional details on the parts of chemotherapy or radiation treatment plan that should NOT be submitted, please navigate to the Chemotherapy and/or Radiation Questions sections.
Do I need to call the patient's insurance company to confirm eligibility?
Yes, unless the patient's insurance information displays automatically on the Enter Patient Information screen in eviti|Connect. This indicates the patient's insurance company is using our automated eligibility feature.
Can I start the patient's treatment as soon as I receive the eviti code?
That is at the discretion of your attending physician, clinical management, and insurance company. While most treatment plans with eviti codes do receive reimbursement, eviti, Inc. does not approve or deny payment or treatment, and is not responsible for determining reimbursement amounts. If you need more information or clarification about your eviti code, please contact the patient’s insurance company.
Can I phone or fax to get a preauthorization?
No. All preauthorizations must be completed online by accessing eviti|
Connect at connect.eviti.com
The treatment plan I submitted did not receive an automatic eviti code, what do I do?
No additional action is required. The treatment plan was automatically submitted to our Medical Office and will be reviewed by one of our oncology certified nurses. If necessary, they will arrange a peer-to-peer between the patient's physician and our oncologist. You will be notified of the decision via email and on your dashboard.
What does an eviti code mean?
When a treatment plan receives an eviti code, it means that the treatment plan is compliant with both evidence-based medicine and the patient’s insurance company plan language. The specific meaning of the eviti code is defined by the insurance company based on their policies. If an eviti code is issued for the patient’s treatment plan, the treatment plan submitter will be sent the eviti code definition and instructions via email. This information is also available on your dashboard. For more information or clarification about your eviti code, please contact the patient’s insurance company.
If the patient’s treatment will be administered at more than one location, do I need to include all of the drugs in the treatment plan or just the drugs administered at my location?
All parts of the patient's treatment need to be included regardless of the administering location (site of service). The administering locations and physicians should coordinate billing and sharing of treatment plan along with its status. For additional details on the parts of chemotherapy or radiation treatment plan that should NOT be submitted, please navigate to the Chemotherapy and/or Radiation Questions sections.
If the patient’s secondary insurance company is not listed as a Payer in eviti| Connect but reimburses for certain drugs, do I need to include those drugs in the treatment plan?
All parts of the patient’s treatment plan must be included, regardless of secondary insurance.