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CommercialPrior AuthHigh impact

Expanded Partnership with eviCore

Healthfirst·Oncology·Prior Authorization
Effective date
Jan 9, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Healthfirst has expanded their partnership with eviCore to include prior authorization management for all medical oncology services across all Healthfirst plans, except for the Senior Health Partners MLTC plan. This means oncology-related services will now require prior authorization through eviCore instead of directly through Healthfirst.

Action Required

Action needed
Immediately: Billing team must update prior authorization workflows to route all medical oncology service requests to eviCore instead of Healthfirst for members in all Healthfirst plans (except Senior Health Partners MLTC). Update staff training on new authorization process. Verify eviCore portal access and submission procedures. Claims will be denied without proper eviCore authorization.

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