Program Spotlight: EviCore by Evernorth’s SmartChoice high-tech radiology redirection program

EviCore by Evernorth^®‘s SmartChoice program is a member outreach and education initiative designed to help patients access cost-effective and convenient in-network services for advanced imaging, including MRI/MRA, CT/CTA and PET scans.

The program helps ensure members receive the right care in the right setting—affordably—while maintaining alignment with provider intent and clinical needs.

How It Works

When a prior authorization request for high-tech imaging is submitted and approved, cases ordered at higher-cost facilities may be routed to the SmartChoice team. From there, the process is straightforward:

1. Member outreach: The SmartChoice team contacts the member by phone, text or mail to let them know their imaging has been approved and to share information about available in-network alternatives in their area.
2. Cost transparency: The member receives cost comparison information for their originally selected facility and nearby alternatives so they can make an informed choice.
3. Logistical support: If the member has scheduling needs, accessibility concerns or other barriers, the SmartChoice team works to address them directly as well.

If the member chooses an alternative facility

The SmartChoice team handles the transition from start to finish, including these tasks:

• Updating the authorization to reflect the new facility
• Verifying that the alternative facility can perform the specific procedure and meet the member’s clinical needs
• Coordinating scheduling and transferring orders from the ordering provider
• Following up with the new facility to confirm receipt of documentation
• Canceling the original appointment (with the member’s approval)

If the member prefers to stay with the original facility

The case proceeds as originally requested; no action is needed on your part. The ordering provider is notified of the outcome, and care continues without interruption.

What This Means for Your Practice

SmartChoice is designed to work alongside your clinical decisions, not around them. The program

• maintains the clinical integrity of your order;
• handles member communication and logistics on your behalf, reducing administrative follow-up;
• promotes affordable, high-value care; and
• enhances member satisfaction and engagement.

Have questions about SmartChoice? Your Regional Provider Engagement Manager is happy to help.