Evicore Healthcare

I had back surgery a little over a year ago, which took 6 months to get that approved by these a-holes. I've been doing great until a month ago something happened and my pain is at a constant level 9. Evicore is forcing PT before they'll consider an MRI. PT is making me worse. I'm averaging a little over a hour of sleep a night. What's the point of PT if they don't know what the problem is and there's no way to know without an MRI. I'd be ashamed to work for that mickey mouse operation. If I wind up handicapped because of there negligent policies I'm going to sue them. I hate evicore.

The score is actually in the negative. This is an awful business that consistently interferes with the re recommendations of all my excellent doctors. I don't even know why I pay premium prices for a PPO plan anymore because this company steps in and practices medicine without seeing me and essentially refuses to allow medicine and procedures my doctors recommend. Additionally, the bureaucratic nonsense this company places on doctors is beyond ridiculous. They require pre-authorizations, but it's standard practice for them to deny all treatment requests and then request offices send the patient's entire medical record. After that they demand the patient do other treatments which are long and arbitrary considering you need diagnostic testing! With that kind of burden, it is no wonder why GOOD doctors are opting out of insurance. Make no mistake, this company and their lineup of of quak doctors are perpetrating fraud at the highest level when they claim they are caring for peoples health. But heck, what is 6 extra weeks of physical therapy before you get the MRI informing you of cancer.

They don’t deserve a one star rating. They sat on my prior authorization for 3 weeks for a simple procedure for my back pain from arthritis, degenerative discs and nerve pain. I had to track down my claim and found it had been “sitting” with them and had been forgotten. They have now denied two scripts that I have been on for a year, one for estrogen and another for sleep apnea. How will America ever claw its way out of insurance fraudsters who claim they know more than trusted physicians while getting rich off its citizens who don’t have the money to spare? How long will the fat cats at the top of the insurance empires get away with crushing innocent hard working Americans? It’s a shame.

United HealthCare approved the MP MRI for my prostate cancer...then,weeks later,in an overnight letter arriving from Colorado today around noon(Saturday)when nobody is available,they said it was not covered.I have agressive cancer and the Fascist Republicans at EviCore(what else could they be to get people killed)want me to die.I think David Michael Cordani deserves the death penalty for being a mass murderer.I would give NEGATIVE 100 stars,if it was possible...or 10 minutes with this thieving CEO.

I have BCN Network ( horrible HMO) through my employer. I had a bicep and rotator cuff tear. They made me go to physical therapy before approving an MRI. I fought for my MRI and scheduled the surgery. They denied my surgery. I had to get a 2 nd opinion ( 2 nd Dr agreed with the 1 st Dr) and appealed. I won my appeal but they didn't approve the entire surgery, they claimed the surgery was not medically necessary! I got my partial surgery and was participating in physical therapy 3 times a week. They now have decided that physical therapy is not medically necessary. This is my dominant arm and have lost significant range of motion. I tried speaking with lawyers and no one will touch it. This feels like medical discrimination to me!

https://www.wsj.com/market-data/quotes/CI/company-people/executive-profile/16538...⇄ /> David Michael Cordani, AKA GOD, current CEO of Cigna, owner of Evicore. Salary 20,000,000. Net worth over 138,000,000.
This Harvard elite playing god earns Millions and lives in luxury, robbing us of our healthcare benefits. This guy decides who lives and dies, and greed is the rule.
Why is a nurse reviewing a doctor's orders for patient care? How many poor & middle-class families paid thousands to Oxford & United health and other healthcare companies to pass off the approval management to this Cigna run evicore? How many people have to suffer and die? We need to break up these companies. They are a monopoly and playing God.
Look at his stock trading. We need to have him FIRED along with all the politicians that Big Dave Cordani supports. People have protested outside his home in the past -- so if you are turned down, you have options. Contact all the funds that are the principal stockholders, let them know what evicore is about, and ask them to divest. Boycott any company Big Dave Cordani is involved in.

The CEO is a Goldman Sachs guy --my guess is decisions are driven by greed vs. medical need. We are paying Bankers to assign who lives or dies. I pay $1,400. monthly for my single policy and can't get an MRI approved. My doctor wrote it, and Evicore denied it now; a nurse has to review my doctor. They even denied my colonoscopy, and I am over 55 with a family history of colon cancer.

Go to the Evicore website and look up corporate governance and their backgrounds. These elite folks are playing God, and we are paying them to do so.
Do the same for your insurance company.
Do a little digging to get their email addresses, and try sending direct messages. If that does work, perhaps sit outside their home with a sign and your grievance. Let their neighbors see how these disgusting humans/thieves play with the desperate seeking healthcare they have paid for.

They have call centers with poorly trained individuals that are just talking heads and provide useless service. Search online how their own employees rate Evicore.

It's time we turn the tables on the elite crooks that are tricking & robbing Americans.

I wish I could give no stars. This company’s moral compass is the low road! They keep denying a procedure I need and instead offer an approval for a lesser diagnostic test my physician is not requesting! When did backstage clerical workers assume the role of doctor….they should be called to the carpet by government watchdogs for inhumane treatment of patients.

They do Not care about the people, they save the money for the insurance companies. From this money they pay to their staff. Shall be prosecuted.

I just received my third denial for an MRI of my lumbar spine, I have had Blue Cross RI for over 20 yrs and have never had an issue until now because EviCore is involved.
I had a double discectomy and laminectomy in 2020 and a couple of months ago started having having horrendous debilitating pain in my lower back again, saw my neurologist and they requested an MRI which was immediately denied!
back and forth EviCore keep hopping in the 6 weeks of physical therapy before they will approve an MRI, my Dr’s are like how can you prescribe PT when we don’t even know what the problem is an the reason an MRI was requested. Well today was the third denial which means I can’t receive or have Dr’s submit anymore requests for at least 90 days unless I pay out of pocket. I filed my appeals today and they can take 60 days, how can an insurance company legally be allowed to take our payments and copay’s if they are willing to deny treatments and have no quality of life and live in pain?
EviCore you are the worst!

Same as everyone else: Evicore (for Aetna) twice denied stat MRI's for a deep wound with staph infection ordered to see if it's advancing/advanced into bone. First denial resulted in ER visit since infectious disease doc wouldn't make a surgical cut without imaging and Evicore demanded an x-ray first. A peer to peer was held with board certified doctor... and a nurse on the other end vs doctor or radiologist. MRI still Denied, they demanded an X-ray first even though doc said it wouldn't show anything useful at this point and it couldn't be scheduled for several days at any of the outpatient imaging facilities... so we were forced to wait while infection raged and wound got deeper. Evicore said outpatient treatment is never "medically urgent." Decided had to go to ER; they did a CT, (thank goodness Evicore isn't involved in ER treatment!) then surgical incision and at this point we had infected wound requiring ongoing IV medication, frequent wound care visits and a PICC line ... due to delay in treatment from lack of imaging thanks to Evicore. A month later, still on the IV antibiotics, frequent wound care visits; new infectious disease doc ordered an MRI for this deep wound to make sure it's not into the bone which requires surgical consult and possible surgery. Denied again... for lack of x-ray. These people are unqualified to make judgment calls about what imaging is appropriate, when baseline cheaper imaging is useful and when it is not needed, and when higher cost imaging IS needed and is urgent. The doc had submitted clinical records which include the wound details. Only because we had a copy of the ER records, sent over the CT reading, and spent 5-6 hours on the phone with Evicore, was the denial reversed. Both requests for authorizations were submitted as Stat and downgraded to "not medically urgent" by Evicore. This is CRIMINAL NEGLIGENCE. By now the insurers KNOW what's going on with this company and are a party to these ridiculous denials of benefits, raking in profit$ by denying services, so don't have an incentive to make changes. We have to find a way to make change to this corrupt system.

Evicore keeps saying they are not receiving the medical info that my doctor is sending them, this has been a cat and mouse for a month, meanwhile I have parts of my lower leg and toes that are numb. I have Aetna, and apparently they have chosen to partner with this monstrosity of a company, and they will not even help with resolving this issue.

These people called me up and didn't even come close to pronouncing my name right. I'm with Medicare with a nice supplement policy, so I don't even know why they would be involved. We work with a local hospital and doctors to take care of our needs. If we have a problem with anything we make free necessary phone calls to the appropriate people and get it solved. That includes coverage and billing.

Evicore is a giant corporation bully that should not be in any sort of area of health care. I was told by Blue Cross Blue Shield that I was overdue for my lung scan I informed the BCBS lady that last year test time I got a letter telling me not to do the test, that I would responsible for payment. So Last year I didn't have it done. So, the other day, once again BCBS said I was due for the scan, I told them I was denied the year before, the lady sounded surprised and said "by us"? I didn't remember this sad a[censored] company. I think it's kind of new with BCBS. So, the lady for BCBS was wonderful...
she told me it would be covered she even did a 3-way call, gave them the authorization number with a radiologist place closer to my home since I don't drive. I even called BCBS the next day to make sure it would be covered. Was told YES once again gave me the authorization number again. NOW in the mail I get a letter from EVICORE saying they will be talking to my doctor, (who is new with me I've only seen twice) to see if I am worthy to live. Doctors and cancer dept of a hospital place said I need the test because I have 3 nodules on my lungs and a few years ago my sister died of lung cancer. I retired early so I am only living on a pension that why I don't do anything before I get the ok from BCBS. NOW if this scan comes back with cancer, I will sue Evicore for not allowing me to have the scan the year before. Why does Evicore not discuss my case with BCBS? They know more about my medical then anyone, they know I went for a heart procedure but the surgeon couldn't continue because of my lungs. So, after that I went to a pulmonary doctor who really helped me and found the nodules. BTW I really felt I needed the test because for some reason the past 11 months my lymph nodes under my chin and on the sides and back of my neck are very swollen. It's all in my files. PLUS, I now suffer from extreme anxiety and depression since my mom's passing. Evicore really has no place in the health care area they try to intimidate and boss around the ill and elderly.

Have terrific back pain and every step I take is painful. Evicore initially denied MRI, then approved after physician initiated peer-to-peer conversation. MRI confirms spinal stenosis and pinched nerve (lumbar). Physician sought approval for caudal epidural. Evicore says not medically necessary. Why is this not unlawful and why do these uniethical practices continue? We, as the American public, need to have our voices heard to change these horrific and harmful practices!

I don’t know why they are in business unless their plan is to further ruin healthcare. I have been in need of an MRI for over a month now and they continue to deny my claim. My doctor has sent them all the info they need to approve it but they still refused it. They are requiring him to actually call and talk to their “doctor” and will then hopefully approve it. They are a huge clog in the already clogged healthcare system in the US. They deserve zero stars.

This company should not be operating. They are delaying authorizations for procedures that are time sensitive and heart related that can result in patient death. My cardiologist requested approval for MRI of the heart and this was not received so they almost cancelled the procedure. I called United Health Care (Wellmed) to intervene. They got approval very late evening before the procedure.
Two weeks later the doctor ordered Catherization with possible stent. The procedure was scheduled for 4/16 and was cancelled late 4/15 because eviCore has not provided the approval. So far no one has any response from them. I called them and they got the request on 4/9 but no one can say if and when it will b e approved.

We've had multiple medically necessary procedures authorized and approved by Blue Cross Blue Shield only to have their partner in crime, EviCore, determine months later the procedures are not covered. When calling EviCore to appeal, they don't give specifics on how to get the situation corrected or how to escalate the issue so it gets the appropriate attention by qualified person. So, our conclusion is that this is nothing more than a illegitimate scheme to defraud patients and providers of money so they can increase their profit margins.

Recently diagnosed with Breast cancer - had MRI, approved no issues. New spot of concern noted in an area that cannot surgically be reached for biopsy. Doctor ordered PET scan 3/3/21 - scheduled for 3/9/21 - no answer given. Appointment cancelled due to no answer. Denied that day - peer to peer initiated. Per peer to peer, was told that a CT and bone scan needed to be completed first - both tests have been pending for days. Submitted 3/11 - test scheduled 3/15. No answer and test is tomorrow at 8am and today is Sunday - they are closed... My doctor office called for hours - Evicore refused to let them speak to nurse or supervisor. Refused to order "urgent" (which Evicore recommended I tell my physician). My doctor office was told "urgent" status can only be given in life or death situations, less than 24-48 hours to live...
Evicore has delayed treatment for me - meanwhile I have cancer growing in my body that could be spreading. Denial reasons have been that I am not stage 3 or 4, but by the time they actually approve something, I will be stage 3 because they have taken so long!
Are they going to do this for my surgery, chemo/radiation? How can I trust this company to actually do what is best for me? I have no faith and no other alternatives.

MY doctor ordered a artery catheterization and I just received word that the authorization was denied. Cigna just switched to evicore in early February for its 3rd party authorization. So my experience mirrors everyone else on this thread.