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CommercialPrior AuthHigh impact

eviCore Notice of Changes to Prior Authorization Requirements

Medical Mutual of Ohio·Oncology, Radiology·Prior Authorization
Effective date
Feb 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Medical Mutual is transitioning radiation oncology prior authorization management to eviCore starting February 1, 2022. The billing team must begin submitting all radiation oncology prior auth requests through eviCore's portal instead of directly to Medical Mutual, with expanded services now requiring prior authorization.

Action Required

Action needed
By January 17, 2022: Billing team must register for eviCore web portal at https://evicore.com/Pages/ProviderLogin.aspx and update workflows to submit all radiation oncology prior authorization requests through eviCore instead of Medical Mutual. Train staff on new process using phone (1-888-693-3211) or fax (1-866-699-8160) as backup methods. Update encounter forms to remind providers that services without prior auth will result in claim rejections and no member billing allowed. Implement 15-day post-service contact requirement for retro authorizations when prior auth is missed.