EviCore

EviCore by Evernorth is a medical benefits management company owned by Cigna. It is based in Bluffton, South Carolina, United States. The company reviews prior authorizations for specialized medical procedures on behalf of insurers. It is the largest prior authorization company in the United States, working with over one hundred insurance companies and Medicaid programs. It also issues medical guidelines.

As an outsourced medical review company, EviCore reviews claims for procedures, which it approves or denies based on the likelihood of approval as determined by an artificial intelligence algorithm. EviCore was formed by the 2014 merger of MedSolutions, Inc, and CareCore National. It was acquired in 2017 by Express Scripts and in 2018 by Cigna, which operates it through the subsidiary Evernorth. In the 2020s, it has used an artificial intelligence algorithm to review the likelihood of a claim being denied, which has been criticized as being motivated by profit. Medical organizations have criticized the company's guidelines for delaying or denying treatment.