The secure Evernorth Provider website offers free, convenient, time-saving tools, including tools for eligibility and benefit inquires, patient liability estimates, precertification, claim status and claim payment and explanation.

Top Reasons to Register for the Evernorth Provider Website

• Check claim status
• Find helpful guidelines and administrative information more quickly and easily
• Review detailed patient benefits and access procedure code benefit lookup
• Enroll in electronic funds transfer (EFT) and receive your payments faster
• Learn what's going on in Evernorth's Behavioral Health organization

What You'll Find

• Enhanced online services let you check patient eligibility, benefit levels and claim status.
• Evernorth's medical necessity criteria - Guidance used in conducting mental health and substance use level of care and medical necessity reviews for all health plan business unless contractual requirements, federal or state law require use of other clinical criteria.
• Clinical Support Tools - Practice guidelines, treatment support tools, and educational materials.
• The Behavioral Administrative Guidelines for behavioral health are available for review and download; includes:
• Clinical Practice Guidelines
• Summaries and tools to meet the complex health needs of customers.
• Treatment recordkeeping standards, audit tools, new technologies, and information on the importance of continuity and coordination of care.
• Toll-free numbers for accessing our staff regarding the Utilization Management process.
• An overview of the Utilization Management process and your right to discuss Utilization Management decisions with a peer reviewer.
• Statement regarding Utilization Management, incentives and compensation, and Customer Rights and Responsibilities.
• Evernorth's information validation and your rights to review your credentialing file and update your information.
• Your right to inquire about the status of your recredentialing application.
• State-specific policies and standards.
• Transformations newsletter features updates on topics such as:
• Quality Program description and results for Evernorth Behavioral Health.
• Results related to network access and availability.
• Our policies on the collection, use and disclosure of customer protected health information.
• Information about preventive health, online self-management tools, behavioral screening programs and coaching and case management services available to your customers.
• Patient safety information and how Evernorth monitors safety, including care transitions, and telephone responsiveness, including language translation and assistance to the hearing and speech impaired.

For an overview and benefits of Provider.Evernorth.com, watch our 3-minute site tour video.