webDENIS Alert:

Training Information for eviCore corePath Model that Launches January 2018

Category: Medicare Advantage

Title: Training information for eviCore corePath preauthorization program that launches in January

Start Date: November 20, 2017 End Date: 1/1/2018

Beginning Jan. 1, 2018, Blue Cross Blue Shield of Michigan in collaboration with eviCore will implement a new therapy authorization model called corePath which is geared to improve operational effectiveness. This model will streamline the authorization process and will be easier for the Medicare Advantage provider community to follow.

The program has been designed to:

·  Reduce administrative burden on providers and their staff

·  Provide recommendations on allocated physical therapy visits based on the severity of the member’s condition and functional loss

·  Apply the authorization to the initial course of treatment only. A second approval must be requested to add physical therapy visits to the member’s treatment plan

·  Empower providers with the ability to identify attributes that are unique to a specific member’s condition

·  Grant approvals for additional physical therapy visits with confirmation that a member’s condition is progressing as expected o A more detailed review of a member’s special needs is required for ongoing care

·  Reduce the amount of clinical information required

·  Integrate professionally accepted standard scores, using validated measurement tools such as Oswestry Disability Index and Neck Disability Index

·  Allow providers to submit and receive same day authorizations in real time

·  Exclude preset maximums and waivers and will be based on the member’s condition and needs

·  Eliminate provider tiers as a factor in the utilization management process

Ø  Blue Cross will grandfather in current Tier A providers

Ø  Blue Cross will still require notification of requested visits from current Tier A providers

To help you make a smooth transition, we’re offering online training on the corePath model.

Training sessions will cover:

·  corePath system

·  Pathways - Requirements for Initial and Follow-Up Requests

·  corePath Forms

Online training dates

corePath Model
Dates / Days of the Week / Time
November 28 / Tuesday / 4:00 PM Central /
5:00 PM Eastern
November 30 / Thursday / 11:00 AM Central / 12:00 PM Eastern
December 4 / Monday / 10:00 AM Central /
11:00 AM Eastern
December 8 / Friday / 3:00 PM Central /
4:00 PM Eastern
December 12 / Tuesday / 9:00 AM Central / 10:00 AM Eastern
December 14 / Thursday / 1:00 PM Central / 2:00 PM Eastern
December 18 / Monday / 12:00 PM Central /
1:00 PM Eastern
December 20 / Wednesday / 4:00 PM Central /
5:00 PM Eastern

Each session is an hour long. The training will be recorded and then available on web-DENIS.

Note: To accommodate resources, we strongly encourage you to attend one of the scheduled training sessions currently offered. However, if the proposed corePath training dates will not meet the needs of your schedule, feel free to contact your BCBSM Provider Outreach Consultant or send a request for additional dates to . We ask that the requests for additional training dates are made at minimum 3 days in advance to the proposed training date that would fit your schedule.

How to register for a training

·  Select a date and time for the program you’re interested in.

·  Go to evicore.webex.com.

·  Click on the Training Center tab at the top of the page.

·  Click the Upcoming tab and find the date and time of the conference you wish to attend.

·  Click Register and enter the registration information.

Note: The sessions are named “BCBSM Therapy corePath Migration.”

After you have successfully registered for the conference, you’ll receive an email containing the toll-free phone number and meeting number, conference password and a link to the web portion of the conference. Please keep the registration email so you’ll have the information for your session.

Your opinion matters to BCBSM. We will request feedback regarding your experience using the CorePath model. Your feedback will be used to assist BCBSM in continuing to provide quality programs aimed at creating a better experience for you.