Provide required documentation

If the treatment plan deviates because the physician prescribed a different treatment, or you chose a clinical trial, you must provide the required documentation so that our medical team can review it.

To provide required documentation, attach the files online, or fax or email them to us within one hour. If necessary, you can attach some files online now, and attach, fax, or email the remaining files as soon as possible.

CAUTION: Due to strict state-mandated turnaround times for preauthorizations (sometimes 24 hours) you must provide the required documentation when you submit the treatment plan, or as soon as possible.

Additionally, we must be able to contact you and the prescribing physician if we have questions about the treatment plan.

If we do not receive documentation or cannot reach you or the physician in time to meet the mandated deadline, we cannot assign the treatment plan an Eviti code and the payer will deny it.

To provide the required documentation, follow these steps:
  1. On the Medical Review Required screen, review the list of required documentation.
  2. Choose an option to provide the documentation.
    OptionDetails
    Attach the documents online now

    In the Attach the documents for medical review below section, follow these steps:

    1. Type a name for the file.
    2. Click Select file.
    3. Find and select the file on your computer or network.
    4. Click Upload.

    Repeat this procedure for each file.

    You can upload the following file types: ​.xls, .xlsx, .xlsm, .doc, .docx, .pdf, .ppt,​ .pptx, .csv, .jpg, .gif, .rtf, .bmp, and .txt.
    Fax or email the documents to the Eviti Medical Office Select the I will fax/email the documents check box, and then click Download Cover Sheet to download a cover sheet that's specific to the patient's treatment plan.

    Fax the cover sheet and documents to 888-468-1423, or email them to [email protected].

    Note: The cover sheet is specific to the patient's treatment plan. Do not use the cover sheet for other treatment plans.
  3. Click Save and Continue.
  4. In the Treatment Plan Summary screen, click Submit Treatment Plan.
    CAUTION: Do not forget this step. You must click Submit Treatment Plan to finish submitting the treatment plan.

If you need an expedited medical review, call NantHealth Support at 1-888-482-8057.

When our medical team reviews your treatment plan, they may email you to request additional documentation. You can attach the documents electronically from your saved treatments list instead of emailing or faxing them. Learn how

After we complete the review, you receive an email that indicates whether we issued an Eviti code to the treatment plan. If we issued an Eviti code, the email includes the payer's Eviti code definition, and instructions about what to do next.