For other uses, see Dominic (disambiguation). Dominic is a name common among Roman Catholics and other Latin-Romans as a boys name. Originally from the late Roman-Italic name Dominicus its translation means Of Our Lord, Lordly, Belonging to God or of the Master.
ï· Call us at 1-888-693-3211. ï· Fax an eviCore healthcare request form (available online) to 1-888-693-3210. Also, to ease the administrative burden of requiring prior authorization of OB Ultrasound studies, providers may batch service requests for up to 12 weeks and cases may be reviewed retrospectively for.
Fax completed form to 1-800-357-9577. If this an URGENT request, please call 1-800-417-8164. . If you have any. ior authorization team at the number listed on the top of this form. Prior Authorization of Benefits is not the practice of medicine or a substitute for the independent medical judgment of a treating physician.