Does an appeal need to be filed by the physician or can it be initiated by the office staff?

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The physician or the office staff can initiate an appeal for all patients except BlueCHiP for Medicare. Appeals from BlueCHiP for Medicare patients must be initiated from the member, but providers may assist the member with the process. eviCore must follow CMS guidelines regarding high-tech radiology denials issued to our Medicare Advantage (MA) members. When a denial is issued, eviCore mails MA members their appeal information with a 1696 form that they must sign. If the member presents to your office and does not have the form that was mailed to he/she, you may contact eviCore to obtain this 1696 appeal form on behalf of the member. eviCore can fax this form to you and you can assist the member in completing this form.  For your convenience, please see the 1696 appeal formYou can file an appeal by fax to (888) 693-3209.

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