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Submit appeals to: EviCore via telephone at 800.792.8744 or fax at 866.699.8128 or by mail at: EviCore Healthcare Attention: Clinical Appeals PO Box 5620 Hartford, CT 06102 First-level medical necessity appeals for Medicare should be submitted to Capital via fax at 888.456.2449 or by mail at: Medicare Advantage Appeals PO Box 779970 Harrisburg, PA 17177-9970 EviCore clinical guidelines for Laboratory Management Services The following information is applicable for molecular and non-molecular laboratory services administered by EviCore for Commercial Fully Insured, select ASO, CHIP, and Medicare Advantage