What is the Oncology Quality Management Program?

What members are included in this program?

What members are excluded from this program?

When will the program begin?

How can a physician’s office request training for this program?

What are some key features of the program?

How do I contact Evolent authorization support?

What is the transition of care process?

Who is responsible for obtaining prior authorization?

How do I obtain prior authorization?

What drugs require prior authorization?

Which radiation therapy modalities require Evolent authorization?

Which specialties are included in the Medical and Radiation Oncology Quality Management Programs?

Who reviews medical and radiation oncology requests?

What happens if the authorization request does not meet guidelines?

What will the Evolent authorization number look like, and how long is it valid?

Which place(s) of service are included in this program?

Which place(s) of service are excluded in this program?

Does prior authorization guarantee payment?

Who is responsible for responding to grievances and appeals?

What will happen if the physician does not request and obtain an authorization?