HAP is currently streamlining requirements for eviCore and HAP authorizations, which began on May 1, 2018. The change is made after their careful review of trended data on practice variations in addition to feedback from their provider partners about potential barriers to care due to its authorization process.
Here is some key change information you need to know:
- Radiation authorization requirements are being discontinued with one exception: proton beam therapy. Proton beam therapy authorizations will no longer be managed by eviCore but will require HAP authorization. HAP will manage these authorizations with no third-party involvement.
- Approximately 65-percent of current authorization requirements for musculoskeletal health care services are being discontinued.
- Codes for services that are being discontinued can be recorded as Tier 1 (no authorization needed) which began May 1, 2018. Approximately 300 codes are affected by this change. For more information, please refer to HAP's Procedure Reference Lists.