Evicore Healthcare Reviews (25)
I have never been denied for steroid injections until a month after switching to this evil company. Same story ... deny, delay, peer to peer (with who knows ?) telling your doctor what they will not cover. Telling your doc his only options. When you go to human resource, they lie to your company and blame your doc.
Like everyone on here, we pay for this insurance to abuse us.
This must stop. This is beyond all understanding. My husband just got denied his stress test and ultrasound scan. I’m sure we will have to pay out of pocket.
This is insanity.
Evicore is an incompetent institution. The staff is ignorant, arrogant and belligerent. They have prevented me healthcare that I pay for and am entitled to. Most likely they get rewarded for denying people healthcare who are entitled to it, because the insurance companies reward them for it. They said that my doctor did not provide enough information. When I called my doctor, he said that he sent all my records and the former preauthorization. In other words, Evicore blatantly lied. Evicore is a dishonest and unethical company. Use them at your own peril. If your insurance company uses them, you should call your insurance company and tell them that you do not want anything to do with Evicore. Evicore stands for EvilCore.
I wish I could give the murderers no stars.
Blue Cross has contracted with eviCore, a for profit company to deny the insureds medical needs. My husband is treated at Mayo Clinic or Minnesota. In the last few months, BCBS has refused to approve the imaging that IS REQUIRED to cure his cancer and save his LIFE. The Choline 11 PET Scan detects cancer when it is nearly undetectable by PSA. My husbands cancer is the most aggressive form of prostate cancer. When there are less than 5 metastasis, a patient can be cured of cancer if the tumors are found when they are extremely small. My husband fits into this category. We see one of the most prominent doctors in the world for prostate cancer. Him and his staff CURE men of prostate cancer using the Oligometastatic concept defined as "A concept that is defined by a state of limited systemic metastatic tumors for which ablative therapy could be CURATIVE. The purpose of localized treatment for oligometasdtases is CURE and the primary outcome to be DISEASE FREE SURVIVAL." Our doctors ARE NOT ordering medically unnecessary Pet Scan imaging! They are necessary to LIVE and be cured. Blue Cross and EvirCore are operating to KILL my husband by taking away the means to be cured. With out dated bone scans and CT scans, the tumors are allowed to get too big to ablate them allowing the cancer to spread. Blue Cross has paid for the Choline 11 PET Scan previously, but once it paired with eviCore, eviCore is denying like crazy stopping at nothing to MAKE A BUCK! We have had to pay $15,000 for our last PET Scan which found two tumors. One pushing my husbands spinal cord. The PET image was needed immediately and used for SBRT Radiation 5 days later. The tumors were completely destroyed! My husband had this procedure outpatient! He is not taking $10,000 drugs. He has never had chemotherapy and is on NO DRUGS! This PET Scan saved BCBS a ton of money and IT SAVED MY HUSBANDS LIFE. The doctors at eviCore totally IGNORE the worlds top doctors explanations why they ordered a LIFE SAVING test, because they REPRESENT the INSURANCE COMPANY. Please help us! There are complaints all over the internet! There is an article in the Minneapolis paper dated 7/20/2020 regarding this exactly. A hospital group has asked for state investigations into Blue Cross and even suggested BC is breaking the law! Meanwhile people are DYING! While BCBS and their on staff radiologist that gets his pay check from eviCore challenges our doctor Eugene Kwon and ACCUSES him of ordering unnecessary tests, we are on our way to GERMANY for imaging! Because BCBS is trying to KILL my husband and many others, we have to go overseas for the IMAGING BCBS is so ignorant of and have the imaging there. WHY WOULD WE GO TO GERMANY FOR IMAGING if it was medically unnecessary! BLUE CROSS AND eviCORE are KILLING PEOPLE! They are cold hearted murders! They are using outdated, antiquated means to deal with cancer and getting away with it. I have no doubt they will be sued and heard accountable for their actions as heinous as they are, but please this could be your family! Stop them now!
Similar experience. They deserve less than zero stars. My physician ordered a stat CT scan based on his clinical evaluation of respiratory issues including pleural effusion to rule out certain diseases such as cancer. An OB/GYN at Evicore denied the the pre-authorization as not medically necessary stating that I am first to have a needle inserted through my ribcage to extract and test pleural fluid. This would require hospitalization and goes against all medical literature and common sense substituting an Evicore administrator judgment for that of my own physician. After exhausting their kangaroo court appeal process, I may be forced to pay cash for the diagnostic and seek redress in court. I sense that I am similarly situation to others aggrieved by Evicore's bad faith practices.
Similar to everyone else. I'm a high risk for certain cancers, and have smptoms that are getting worse. Evicore kept denying tests. except there is no next test other than what my DR ordered. Has anyone looked into a class action lawsuit?
Please write the insurance commissioner in your state asap! Also I reported Evicore to the BBB. I have called my employer and reported a violation in our benefits. WE as employees at my company were NEVER TOLD there was going to be HUGE loss in our benefits we had enjoyed. I could have chosen a different provider! I have asked my company for an appeal to change carriers. We have over 120,000 employees so I'm going to let as many as I can what BCBS has done.
We are flying to Germany for imaging. I am going to BLOG/ Facebook/Twitter these murders into the ground. My husbands cancer is INCURRABLE without imaging! BCBS/EviCore have taken all hope away from my husband being cured of his prostate cancer. We are lucky and can seek MODERN, CURATIVE healthcare in Europe. NOT EVERYONE CAN!
I am not going to stop until these f*g crooks stop. I am a very healthy woman and I have all the time in the world to advocate for those that can not. I will not go away BCBS and eviCore. You slime balls... I'm making it my life to expose you! I'm going to let all the papers know and news channels. I see you were just in the paper in Minneapolis this week being investigated by the state of Minnesota. You may think you will win you ss but you will not.
Complaints are everywhere. The wheels are coming off eviCore. You are going down.
Please help. My little sister has had the same reoccurring denial/bs while in chemotherapy for stage 3 Hodgkins Lymphoma . She is now 2 years into remission. Unfortunately her 6 month CT (Evicore denied quarter CTs although standard for her kind of cancer for 2 years) came back abnormal and you guessed it Evicore is dragging their feet and if history repeats itself they will deny the restaging PET the Dr. wanted 3 days ago. My sister has a 2 and 4 year old ( yes she was diagnosed 2 weeks after delivery... It's been hard). What is the appropriate process for making formal complaints against agencies like this? I will most likely be the one helping her with this process. Needless to say we are scared and pissed. If the cancer has returned Evicore should be held liable for denying the quarter CTs that would have caught this earlier! There are 2 babies involved!
We thought we had good healthcare... boy was I wrong... I work for Lockheed Martin and insured with AETNA and pay good money into this plan... My wife and I have never been sick never missed a day of work. We are now in the fight of our lives not just because my wife has been diagnosis with a rare type of cancer but because our healthcare who uses evicore as a 3rd party approver will not approve test and treatment that oncologist have requested from the University of Penn. We are going into our 3rd week of delays / denials that evicore has rejected. I've contacted congress and is working on hiring a lawyer but if anyone has any other info on how we can stop evicore existence please let me know.
I will work with you if you want to contact me. I'm going to push for a class action suit.
The ABSOLUTE WORST! Impossible to deal with and working in primary care constantly getting denials on test our MD's orderCringe when I see a patient is scheduled for a test and has an ns plan that is contracted with them Really hope people sue them left and right!!
Unethical, criminal, heartless and a joke in the "review vender" world. I've been inside the medical insurance/billing industry for almost 40 years. NEVER have I seem such blatant disregard for patients health care. Evicore is a vender that is contracted and PAID (probably very well) by Companies to review and approve high $$ diagnostic treatments. My husband worked 17 years at his company...barely used his healthcare in all that time. Turns out that after a work comp injury that required surgery, the very skilled surgeon found 3 tumors. She removed one, biopsied it and dang...it was a very rare type of cancer. After 18+ months of various treatments (2 different chemo sessions, immunotherapy, radiation therapy) we noticed that his much needed PET scans were being denied as "not medically necessary). PET scans to track the progressing of Stage 4 cancer? What does he have to have in order to qualify for a PET? I originally assumed the denials were from his health plan. After 3 weeks of calling various departments with our Payer, I finally got in contact with a gentleman that told me that it was EVICORE denying the treatments, wasting our Oncologists time with 'peer to peer' reviews. Now...in order to have a 'peer to peer'...one must assume that all the 'peers' have similar professional backgrounds and credentials. So, being the Analyst I am, I did a public search on the Federal registry (NPPES) to learn something about these "Doctors" that are 'reviewing' and signing their names on the denials. I was horrified what the National Registry listings showed about these 6 "Specialists" determining my husbands health treatment. Not ONE SINGLE ONCOLOGIST! Not even an Oncology Nurse!
Dr. 1 had listed out a Psych, Dentist, Physician Assistant, Radiologist. Dr 2 had listed out a Family Medicine. Dr 3 (your going to LOVE this one) listed out a Speech Pathologist and an OB/GYN (are we birthing out tumors these days?). Dr 4 had a ton of listings ranging from Chiro, PT, Dermatology, Ortho, DDS, Psych, Occupational Therapy (to name a few). Dr 5 listed out Mental Health, Dietician, PT, DDS and even a Doula!. Final Dr 6...only listing was for an Internal Medicine. QUESTION: How do ANY of these "medical professionals" consider themselves in the same category as the 3 highly skilled, very reputable Cancer Specialists that are treating my husbands cancer?
Now that I know it is EVICORE that is the issue...and knowing my husband needs yet another PET scan to make sure this cancer isn't spreading...I am well prepared for a battle with these greedy pinheads.
I have already contacted our Congresswoman, have a contact in the Department of Labor, researched all the findings with tour Payer, filed a complaint with the Employer who hired and pays EVICORE for their "services" and am currently drafting a formal complaint with the Insurance Comissioner. Once the next denial gets in my position...I will contact EVICORE directly and let them know that I am onto their illegal gig. Depending on their response...next step is to take it to the media. Be it the local news, newspapers, social media...anyone that will listen. Hopefully...the employer who is utilizing this "Unethical Sham" will see/hear my words, seek out reviews on these jokers and disassociate themselves with such a toxic organization. Lord knows that if enough bad PR is out there about EVICORES tedious practices...Employers will stop using them as a cost saving contractor...and Health Plans will again be able to determine that treating Physicians know FAR more about their patients than some Dentist who is simply scanning over a few pages of medical records. I'm fairly certain there will be a whole lot of TRUE Health Care professionals that will back us in bringing this company DOWN. Just think of all the patients they can treat instead of wasting time doing "peer to peer" chats with inferior, unexperienced providers! Seriously...my blood boils picturing our Doctor discussing cancer care with a Chiropractor!?!?!
Be forewarned EVICORE...I have way too much knowledge in this industry and too much passion to get my husband treatments to be successful to allow YOU low-life's to endanger lives any longer!
And if you...who are looking up and researching this company...have ANY similar experiences as those of us who are sharing? I suggest you follow the same steps. Share your experience, document everything, look up the denying Doctor name on the NPPES website, call your Congressional Reg (Congress over-sees healthcare issues), let your employer know that they are setting themselves up for a class action lawsuit...and most of all...SHOUT OUT YOUR STORY ANY CHANCE YOU GET! Your life...no doubt...may be whats on the line here! (PS...can I do a negative 20 star...in blood red?)
How do get your denial doctor’s name?
They are very secretive about that info.
I spoke to my therapist and she said when she has had to do a peer to peer, she can tell the person she is speaking to does not have the same knowledge or training that she has. It’s very frustrating.
If you have a valid complaint with this agency, according to the US Justice Dept., who was contacted for assistance, you need to go to Medicare.gov and file a complaint against them! They are denying thousands, across the US, the Dr. requested medical tests to determine treatment. In some cases, even the treatments are being denied. Time to take action folks! Can't keep sitting on the sidelines rooting for someone else to go get em... FILE THE COMPLAINT!
This is a bunch of yahoos all they do is deny procedures and MRAs - MRIs that your doctors say you need to figure out what is going on with something but they just deny saying not medically necessary what the he** dose that mean? This bunch and the insurance companies would rather you die than to try to prevent something before it gets to that point. Doctors say they have never seen anything like what is going on with this bunch of yahoos. Well I hope that they are ready for a lawsuit because that is what is going to happen if what they denied causes major complications or death to my wife. I had to give one star because it wouldn't let me post without a rating
This company is horrible to work with they routinely deny covered medical procedures which causes the provider and patient to waste time re submitting clinical datat they already have They have been overturned many times after appeals One example is they approved a scan, that scan could not be dome so they denied a second scan that was scheduled to take the place of the first scan When this was pointed out they cam up with another reason to deny the mascan Doctors sitting behind desks getting paid to deny requests the doctor that is seeing the patient makes Sham
Horrible They denied my doctor's order and then again after the peer to peer meeting My denial is signed by "Chief" medical officer Gregg PA*** I looked at his areas of specialty and my illness, breast cancer, is not listed In my view this is an ignorant bunch of people with no connection to the patient Actually since they use a checklist to determine whether a procedure is covered they could use admin assistants I would at least feel like they were being honest and just following rules rather than being greedy Enjoy the golf course "Dr" A*** or whatever you will use your excess money on Just hoping I don't have breast cancer that the MRI could have caught My family will just have to sue your company As for *** dodging its responsibilities in favor of EviCore, greedy cowards all
The occupational therapist we talked to was not knowledgeable about pediatric occupational therapy. All the information she provided was based on a rehab model which is not compatible with the neurodevelopmental care we provide to the children. Evicore is also limiting our scope of practice. We have professional training, graduate degrees and state licensure and they are not allowing us to exercise our clinical reasoning skills. This company is denying services to children and families that are thriving because of the occupational therapy we are providing. Evicore is stating that any skill deficits with an underling sensory integration challenge must only be treated through a home program. They state this is based on evidence yet they are not able to produce a data set to support this claim.
The ABSOLUTE WORST! Impossible to deal with and working in primary care constantly getting denials on test our MD's order. Cringe when I see a patient is scheduled for a test and has an ns plan that is contracted with them.
Really hope people sue them left and right!!
Horrible, heartless, selfish, greedy is what this company represents. They are not the doctors working with the patient with cancer they are the junk yard dogs that guard insurance money. Hope they all suffer the same fate of illness and have to go through a begging process for what they are paying for!!!!! Disgusting company
Bills weren't even paid to providers and after 3.5 hours back and forth with them and Cigna, results stated that the system didn't upload between them.