Clinical Information to Establish Medical Necessity

eviCore approves tests or treatments only when providers submit legible, sufficiently detailed medical records—requests with unreadable or insufficient records are excluded and will not be approved. Required documentation includes a recent virtual or in-person detailed history and physical plus pertinent laboratory, imaging, pathology, and procedure reports and reports from other treating providers.

"eviCore applies an evidence-based approach to evaluate the most appropriate medically necessary care for each patient."

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