Physical and Occupational Therapy Services for HCP’s EmblemHealth Patients
Update to eviCore healthcare (Palladian) Services Effective April 1, 2024
As of, April 1, 2024, HealthCare Partners will no longer use eviCore healthcare (“eviCore”) for health plan sponsored services* offered through your Palladian/eviCore PNP Agreement. This program termination is effective March 31, 2024.
What You Should Do Next
Please continue to treat HealthCare Partners members and submit claims to Palladian for all dates of service prior to April 1, 2024. Claims for these services as of 4/1/2024 should be submitted to HealthCare Partners or the managing entity as listed on the member’s ID card.
*Please note: Effective 1/1/2024, Preauthorization and referrals will no longer be required for these services
Dates of Service prior to 12/31/2023 Require Preauthorization and Referral
Access the Palladian Website to locate Physical and Occupational Therapy providers for your patients in need of these services.
The provider needs to refer the member for a P/T or O/T evaluation. The request for a referral is made to HCP via EZ-NET.
At their first appointment, your patient must have a referral for therapy. The P/T or O/T will then develop a plan of care that will be shared with Palladian. They will manage the patient’s care in collaboration with the therapist through their Utilization Management program.
Authorization for additional care will be submitted to Palladian directly by the therapist.
Claims for HCP-managed members with EmblemHealth are submitted directly to Palladian Health.
If you should have any questions regarding this change, please contact HealthCare Partners Provider Services at (516) 746-2200.
Physical and Occupational Therapy Services for HCP’s Anthem Medicare Members
Anthem Medicare members in need of Therapy services can visit an Anthem in-network Physical or Occupational Therapist for an initial evaluation. No Prior Authorization is required for this visit. The therapist will then submit requests for additional services to HCP for review.