Your Utilization Management Category

As part of this program, eviCore conducts a network assessment every six months to compare practice patterns among participating providers. Using the health plan's claim data compiled in the Practitioner Performance Summary (PPS), your practice's Risk-Adjusted Visits per Episode (RAVE) is compared to that of your network peers to determine your category placement.

An analysis of your performance history for the most recent reporting period is summarized below. The table displays the results of the analysis and the key performance benchmark used to determine your Utilization Management Category.

If you did not have at least 10 patient episodes in the 12-month reporting period, you are considered a low volume practitioner. A utilization profile is unavailable.