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Defines eligibility: authorization from eviCore is required for all members for outpatient elective/non-emergent services, while prior authorization does not apply to emergency rooms, observation services, or inpatient stays. Summarizes covered advanced imaging, cardiology, and interventional pain categories, and directs providers to complete CPT code lists via the eviCore site. Explains request submission methods through the provider portal, web, phone, and fax, including portal benefits and e-notification.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/advanced-imaging-cardiac-imaging-pain-management-provider-orientation-session-for-aetna-better-health-of-kentucky/281215/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/advanced-imaging-cardiac-imaging-pain-management-provider-orientation-session-for-aetna-better-health-of-kentucky/281215.png","ImageObject",442,249,{"name":88,"@type":89},"Jake","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-31","2026-09-16",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"When are prior authorization requests required for Aetna Better Health of Kentucky members?","Question",{"text":109,"@type":110},"All Aetna Better Health of Kentucky members require an authorization from eviCore. Prior authorization applies to outpatient elective/non-emergent services.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"For which settings does prior authorization not apply?",{"text":114,"@type":110},"Prior authorization does not apply to services performed in emergency rooms, observation services, or inpatient stays.",{"name":116,"@type":107,"acceptedAnswer":117},"What are the main ways to submit prior authorization requests to eviCore?",{"text":118,"@type":110},"Providers can submit requests via the eviCore Provider Portal (preferred), through web, by phone (888-693-3211, Mon–Fri 8 am–9 pm local time), or by fax (844-822-3862), including adding supporting clinical information.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},281215,1791732575,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":141,"read_time":142},962084928904,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Advanced Imaging, Cardiac Imaging & Pain Management  \nProvider Orientation Session for Aetna Better Health of Kentucky  \n©2020 eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  \nAgenda  \n• Program Overview  \n• Submitting Requests  \n• Prior Authorization Outcomes, Special Considerations & Post Decision Options  \n• Provider Portal Overview  \n• Provider Resources  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  2  \nProgram Overview  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  3  \nAetna Better Health of Kentucky Prior Authorization Services  \neviCore healthcare (eviCore) will begin accepting prior authorization requests on November 1, 2017 for dates of service November 1, 2017 and after.  \n\n| Applicable Membership: |\n| --- |\n| • All Aetna Better Health of Kentucky members require an authorization from eviCore. |\n\n\n| Prior authorization applies to the following services: |\n| --- |\n| • Outpatient\u003Cbr>• Elective / Non-emergent |\n\n\n| Prior authorization does NOT apply to services performed in: |\n| --- |\n| • Emergency Rooms\u003Cbr>• Observation Services\u003Cbr>• Inpatient Stays |\n\n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  4  \nRadiology Solution  \nCovered Services:  \nAdvanced imaging services  \n• CT, CTA  \n• MRI, MRA  \n• PET, PET/CT  \n• Nuclear Medicine  \nTo find a complete list of radiology Current Procedural Terminology (CPT) codes that require prior authorization through eviCore , please visit:  \n[https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky](https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky)  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  5  \nCardiology Solution  \nCovered Services:  \nAdvanced imaging and diagnostic services  \n• Stress Testing  \n- Myocardial Perfusion Imaging  \n- Stress Echocardiography  \n• Cardiac CT, MRI, PET  \n• Echocardiography  \n• Diagnostic Heart Catheterization  \nTo find a complete list of cardiology Current Procedural Terminology (CPT) codes that require prior authorization through eviCore , please visit:  \n[https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky](https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky)  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  6  \nMusculoskeletal Solution  \nCovered Services:  \nInterventional Pain  \n• Spinal Injections  \n• Spinal Implants  \n- Spinal cord stimulators  \n- Pain Pumps  \nTo find a complete list of Interventional Pain Management Current Procedural Terminology (CPT) codes that require prior authorization through eviCore , please visit:  \n[https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky](https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky)  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  7  \nSubmitting Requests  \n ©eviCore healthcare. All Rights Reserved. This presentation contains CONFIDENTIAL and PROPRIETARY information.  8  \nMethods to Submit Prior Authorization Requests  \neviCore Provider Portal (preferred)  \n• Saves time: Quicker process than phone authorization requests  \n• Available 24/7: You can access the portal any time and any day  \n• Save your progress: If you need to step away, you can save your progress and resume later  \n• Upload additional clinical information: No need to fax in supporting clinical documentation, it can be uploaded on the portal to support a new request or when additional information is requested  \n• View and print determination information: Check case status in real-time  \n• Dashboard: View all recently submitted cases  \n• E-notification: Opt-","cbCairs4uw28J32Q","https://ap.wps.com/l/cbCairs4uw28J32Q","pdf",2979725,54,"English","# Agenda\n## Program Overview\n## Submitting Requests\n## Prior Authorization Outcomes, Special Considerations & Post Decision Options\n## Provider Portal Overview\n## Provider Resources\n# Prior Authorization Services\n## Applicable Membership\n## Prior Authorization Coverage and Exclusions\n# Radiology Solution\n## Covered Services\n# Cardiology Solution\n## Covered Services\n# Musculoskeletal Solution\n## Interventional Pain","[{\"question\":\"When are prior authorization requests required for Aetna Better Health of Kentucky members?\",\"answer\":\"All Aetna Better Health of Kentucky members require an authorization from eviCore. Prior authorization applies to outpatient elective/non-emergent services.\"},{\"question\":\"For which settings does prior authorization not apply?\",\"answer\":\"Prior authorization does not apply to services performed in emergency rooms, observation services, or inpatient stays.\"},{\"question\":\"What are the main ways to submit prior authorization requests to eviCore?\",\"answer\":\"Providers can submit requests via the eviCore Provider Portal (preferred), through web, by phone (888-693-3211, Mon–Fri 8 am–9 pm local time), or by fax (844-822-3862), including adding supporting clinical information.\"}]","Advanced Imaging, Cardiac Imaging & Pain Management - Provider Orientation Session for Aetna Better Health of Kentucky | PDF",1789564939,19]