Durable medical equipment (including orthotics and prosthetics) and home health care


EviCore by Evernorth® (EviCore) manages home health care, durable medical equipment (DME), and orthotics and prosthetics (O&P) services for Cigna Healthcare® commercial customers. EviCore has a national network of providers who offer these services.


As of March 7, 2026, EviCore manages the clinical utilization management review process in addition to maintaining existing processes for DME and O&P.


DME & O&P service administration

EviCore is responsible for the following:

  • Provider contracting, credentialing, and demographic updates
  • Claims processing for Shared Administration Repricing and Payer Solutions customers
  • Precertification requests
  • Provider and customer approval and denial letters for requested services
  • Customer-based services, including first level clinical appeals
  • Customer care coordination efforts
  • Initial Precertification requests for Home Health Care services (forwards precertification request/information over to Cigna Healthcare for review and final determination)

Cigna Healthcare is responsible for the following:

  • Claims processing, except for Shared Administration Repricing and Payer Solutions customers
  • Customer-based services, including benefits, eligibility, and second-level appeals

EviCore-provided services

The following table provides examples of EviCore-provided services.

SERVICES EXAMPLES
DME Beds, wheelchairs, walkers, scooters, off-the-shelf DME (braces, splints, slings), and compression (tight-fitting) clothing for all body areas to help post-surgery healing and improve circulation
O&P Prefabricated and fabricated (custom) O&P, postmastectomy supplies (bras, forms, and compression sleeves), and wigs
Respiratory equipment Oxygen, continuous positive airway pressure equipment, and ventilators
Enteral nutrition Pumps and enteral nutritional support
Home health care Nursing, therapies, social work, and home health aides
Other specialty services Insulin pumps and supplies, continuous passive motion machines and supplies, wound vacuums and supplies, and breast pumps

Service coordination through EviCore

To order EviCore-provided services for your patients with Cigna Healthcare-administered coverage, contact a participating provider. To find a participating provider, call EviCore at 800.298.4806 or search on Find a Doctor.

 

You may request precertification through EviCore in the following ways:

For additional information, refer to the EviCore Provider Resources website. The website includes several educational materials: frequently asked questions documents, quick reference guides, provider training presentations, DME and O&P precertification form, and lists of Healthcare Common Procedure Coding System codes that require precertification through Cigna Healthcare.

 

Other services and supplies provided in the home through national providers

The services and national providers are outlined below:

  • Cardiology devices and equipment and heart monitoring equipment and services, including arrhythmia monitors, Holter monitors, and digital and wireless monitoring:
    • Advanced Cardiac Monitoring, Inc.: 800.445.0272
    • Bardy Diagnostics, Inc. dba BDx Solutions, Inc.: 281.453.2100
    • Boston Scientific (Preventice Services, LLC): 888.747.1442
    • CardioLabs, Inc.: 800.304.1098
    • CardioNet, Inc. (BioTelemetry, Inc.): 866.426.4402
    • iRhythm Technologies: 888.693.2401
    • Medicomp Inc.: 877.996.5553
    • MediLynx Cardiac Monitoring: 855.847.1009
    • Pacemaker Monitoring Center, Inc. dba Cardiac Monitoring Center: 800.399.8622
    • Remote Cardiac Services: 877.640.9587
    • Zywie, Inc.: 877.858.7200
  • Wearable cardiac defibrillators:
    • Kestra Medical Technologies: 833.692.7787 (ASSURE)
    • ZOLL Medical Corporation: 800.543.3267 (LifeVest)
  • International normalized ratio services and rapid diagnostic test to measure clotting time for patients using blood thinners:
    • Alere Home Monitoring, Inc. dba Acelis Connected Health Services: 800.563.5801
    • CardioNet, Inc. (BioTelemetry, Inc.): 866.426.4402
    • mdINR: 800.877.4910
  • Hearing aids, replacement hearing aid batteries for non-rechargeable hearing aids, charging stations for rechargeable hearing aids, supplies, and personal sound amplification products:
    • Amplifon Hearing Health Care: 888.669.2175
  • Fetal monitoring services, including use of electronic devices to check a baby’s heartbeat before and during childbirth, electronic fetal monitoring, fetal stress tests, and baby heartbeat monitors:
    • Optum Women’s and Children’s Health, LLC: 800.950.3963
  • Home health care:
    • Healthy Connections Home Care Services, Inc.: 888.304.1800
  • Airway clearance devices
    • Electromed: 952.758.9299
  • Compression therapy products for lymphatic and venous disorders
    • Luna Medical, Inc.: 800.380.4339
  • DME, including off the shelf and drop ship to home (braces, splints, slings, canes, walkers, prefabricated O&P, and knee supports)
    • DJO, LLC: 800.336.6569