Generate an Eviti code for medically justified variances

If a treatment deviates from evidence-based care or your health plan language, we may determine that the deviation is medically justified.

Example

A treatment plan may deviate, for example, if the patient cannot follow the regimen exactly. The patient may live far from the hospital and cannot get to the hospital for treatments as often as the regimen specifies. Although the patient cannot follow the best practice for the regimen, we think it's appropriate care and that you should approve the treatment plan.

Choices

• We provide you with all of the documentation and request your approval before we assign the treatment plan an Eviti code. The treatment plan appears on the Approval Req'd tab of your payer dashboard.
• We assign the treatment plan an Eviti code without sending it to you to review and approve. The treatment plan appears on the Eviti Code and All Records tabs of your payer dashboard.

Best practice

We assign the treatment plan an Eviti code without sending it to you to review and approve.

Enabling this feature expedites the treatment authorization process so the patient can begin treatment sooner.