eviCore healthcare (formerly known as MedSolutions) is Cigna's exclusive radiology benefits manager, performing precertification of high-tech radiology services (MRI, CT, and PET) and high-tech radiology diagnostic cardiology services.
Cigna’s national program features a support and outreach program called Informed Choice. The goal of the program is to educate members undergoing an MRI, CT or PET scan about their options for geographically convenient and cost-effective facilities as they and their doctors choose where to have the tests done.
After a physician contacts eviCore healthcare for precertification of coverage of an MRI, CT or PET scan, a specially trained representative may contact the member by phone and provide information about conveniently located credentialed participating facilities (hospitals or free-standing facilities) and offer appointment options. eviCore healthcare representatives can also provide cost comparison information, so that members are aware of the financial impact of their choices.
eviCore healthcare can assist members in scheduling an appointment at the individual’s facility of choice and complete the referral for the services that have been authorized for coverage. In addition, if the member has additional questions about benefits, account-based balances (e.g., HRA or HSA), or other plan details, the eviCore healthcare representative can connect directly with Cigna's customer service team.
This proactive outreach occurs only when true opportunities for choice exist, such as when the ordering physician has requested a higher cost radiology center or hospital for services and other participating credentialed centers offer the same services at a lower cost.