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Medical management

We provide a wide range of medical management programs designed to support our members at any stage of health. These programs are targeted to specific conditions or are designed to improve or maintain overall health.

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Physical medicine

We partner with eviCore Healthcare (eviCore) to manage our Physical Medicine program for spinal surgeries, pain and joint management, physical medicine and therapies.

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Sleep medicine

We partner with Carelon Medical Benefits Management (Carelon) to manage our Sleep Medicine program to manage testing and therapy services for sleep disorders.

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Radiology

Carelon administers our radiology program, which reviews services performed in an outpatient, elective setting.

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Cardiology

We partner with Carelon to manage our cardiology program, which reviews outpatient cardiovascular tests and procedures.

Review program

Pharmacy

Explore our members’ prescription benefits and other medication information. Learn more about special member programs, pharmacy pre-authorization and our formularies.

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LabCorp

Laboratory Corp. of America is our lab of choice. We encourage you to refer patients to LabCorp for outpatient lab and pathology services.

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Peer-to-peer review

Learn how to request a conversation between a licensed Regence physician or clinical reviewer and the physician or other health care professional.

Request a review
Care management
Personalized care support
Diabetes management
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Does your patient need support?

Regence care management supports the unique needs of members with acute, chronic and major illness episodes or severe illness conditions.

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Palliative care

Our program focuses on supporting the health care needs of our members and families at any stage of life or illness.

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Support for members with diabetes

We are committed to ensuring our members who are living with diabetes receive the best care, treatment and information.

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Kidney health management

Our kidney health management program improves care and outcomes for eligible members with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The program focuses on early detection, proper care and treatment as the most effective approaches to delay the disease’s progression, enabling patients to live better, longer lives.

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Carelon and eviCore are separate and independent companies that provide healthcare management and pre-authorization services for Regence members.