Chantal, 59, was due for her annual mammogram and colonoscopy—two key preventive screenings often delayed or missed. Her health plan’s partnership with EviCore’s preventive care team created an opportunity to help her stay on track.
EviCore’s preventive care outreach team contacted Chantal to coordinate both screening tests, so she didn’t have to navigate it by herself.
Connecting members to preventive care
Once Chantal visited her primary care doctor, the colonoscopy referral was added to her file—another hurdle to screening cleared.
Exceptional member experience
Delivering on the promise of prevention
Her colonoscopy needed a referral from her primary care doctor before completing the test. The care team called to help Chantal navigate this next step.
Navigating the path to a colonoscopy
Screening mammograms reduce breast cancer deaths by 22%. That’s why our team supports members every step of the way—from explaining their screening benefits to helping them book an appointment and confirming it was completed. We work to find options that fit their needs, whether that means weekend availability, same-day appointments, or times that work with their schedule.
Chantal's colonoscopy, however, required additional coordination.
When the care team member contacted Chantal’s primary care doctor for the referral, they learned she needed an office visit prior to the colonoscopy. They scheduled the appointment for her during the same call.
The care team scheduled Chantal’s colonoscopy at a facility close to her home, making it as convenient as possible.
With over 25% of eligible adults skipping this potentially life-saving screening, every completed appointment counts.
Evernorth Medical Benefit Services works with health plans to identify members like Chantal who are overdue for important health screenings and provides the hands-on coordination they need—from scheduling support to in-home tests. The goal: transform preventive care from a coverage benefit into completed screenings that drive meaningful improvements in member health.
THEN WHAT?
CHANTAL'S COLONOSCOPY
Clinical review
We ensure procedures are in accordance with the most up-to-date literature and national guidelines to promote the most clinically appropriate and cost-effective care for each patient.
A peer-to-peer discussion enables a patient’s physician to discuss a complex case with an EviCore medical director with experience in the same specialty. During a P2P, the doctors discuss how the clinical guidelines apply in these particular circumstances.
Peer-to-Peer (P2P) Discussion
*Not patient’s real name. Images are for illustration purposes only.
SCHEDULE THE APPOINTMENTS
or email us at
MSK@evicore.com.
Meet Chantal
Chantal thanked the team before hanging up: “EviCore gave me that really personal touch I needed to get out and get that fire under me to go to the doctor.”
EVICORE PREVENTIVE CARE OUTREACH
The difference between a missed screening and a completed one often isn't member motivation—it's navigation support. Catching cancer just one stage earlier can save an average of $60,000 in treatment costs—making a huge difference for both the member and the health plan.
Evernorth Medical Benefit Services Preventive Care Outreach provides that support, helping members manage the complexity that often stands between intent and action.
Preventive measures, like Chantal’s mammogram and colonoscopy, can reduce premature deaths by up to 40%—but only when members actually complete them.
A peer-to-peer discussion enables a patient’s physician to discuss a complex case with an EviCore medical director with experience in the same specialty. During a P2P, the doctors discuss how the clinical guidelines apply in these particular circumstances.
Peer-to-Peer (P2P) Discussion
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A care team member helped schedule Chantal’s mammogram over the phone at an in-network facility—making it simple for her to take advantage of a benefit she didn’t even know she had.
EviCore by Evernorth proactively reaches out to members who may be due for important preventive screenings. Through a quick phone call, we help them understand their no-cost screening options and assist with scheduling at convenient, in-network locations—removing barriers and making care easier to access.
Primary care visit
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