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AHII Oncology Clinical Pathways Pilot

The Oncology Clinical Pathways Pilot is the latest installment of initiatives under the Alabama Health Improvement Initiative (AHII). This pilot seeks to assess and promote the use of evidence-based treatment protocols in medical oncology practices across Alabama. The goals of the pilot are to:

On the May 6, 2013, official pilot launch date, Blue Cross will deploy Web-based tools from a third party vendor named eviti® through a relationship with Prime. Participation in the pilot allows medical oncology providers access to eviti | Advisor®, a decision support resource that empowers oncologists with a comprehensive, unbiased oncology treatment guidelines library for use at the point of treatment and prescription. Pilot participation also allows access to a companion tool called eviti | Connect®. This tool allows oncologists to enter patient-specific drug treatment regimens and clinical trial participation information and engage in a voluntary review to assess their proposed treatments for compliance with evidence-based standards. Physicians in the pilot will receive an incentive for their efforts at the conclusion of the pilot.The pilot will conclude May 21, 2014.

Beginning on May 1, 2014 all medical oncology providers will be required to use the eviti | Connect® and eviti | Advisor® tools. Claims without an eviti code will not be denied until January 1, 2015. However, upon retrospective review, if a treatment plan was found to be submitted through the eviti tool, claims could be denied and refunds sought. Threrefore, providers should utilize the eviti tool for claims processing as of May 1, 2014, to avoid any refunds being initiated.

Additional training will be available for practices that request it or did not participate in the pilot.

Blue Cross is dedicated to making sure that providers receive the necessary training for the eviti tools. Providers may contact their Provider Network Services Representative at 1-866-904-4130 with any questions..

An independent health information technology company, eviti, Inc., delivers Web-based decision support services to improve the quality of cancer care.