Referring physicians must obtain prior authorization from CareCore National for the following radiology services:
- PET Scans
- CT Scans
- Nuclear Cardiology
Follow this link to view the list of current CPT codes included in the radiology authorization program.
Conventional x-rays and ultrasound studies do not require preauthorization. In general, Excellus BCBS follows CareCore National criteria for radiology imaging. However, after an independent review of the evidence, our corporate medical policy committee has made limited modifications.
To Request or Check the Status of an Authorization
You can request preauthorization online or by fax:
Tips for Accessing the CareCore Web Site
For Physicians & Office Staff –
To protect against patient privacy, your Excellusbcbs.com Username was associated with a specific physician ID ("P010" number) when you registered. The CareCore Web site will identify you using that provider number.
- If you are in a group practice, you can request preauthorizations for any physician in the group by selecting the appropriate physician name. When checking status on authorizations for a patient, all authorizations for the group will be displayed for that patient.
- Both referring and servicing physicians and staff can now log in to the CareCore Web site:
- Referring physicians and staff can request authorization, check the status of authorizations or verify if preauthorization is required.
- Servicing physicians and staff can check the status of authorizations or verify if preauthorization is required.
- For questions about using the CareCore Web site, please call CareCore directly at 1-800-918-8924 ext 10036. If you experience difficulty connecting from our Web site to CareCore, please call our Web Security Help Desk at 1-800-278-1247.
For Hospital Staff -
We are working to provide you with online access to CareCore in the coming weeks. In the meantime, you can call CareCore directly at 1-866-889-8056.
View our Provider Reference Guide (PDF) for information about the CareCore National imaging management program. The guide contains contact information, urgent and emergent imaging process guidelines, directions on how to file an appeal , and other pertinent topics. Follow the links below to learn about the Appeals Process: