Referral Pattern Analysis
   and Modification
    Tracking Physician Ordering Patterns

RadAlert™ allows payers to monitor radiology exam ordering patterns and identify providers who may need ordering behavior modification training. HealthHelp works with payers to establish minimum guidelines designed to recognize physicians who may be ordering unnecessary tests. When software alerts detect problematic patterns, plan administrators may choose to conduct chart reviews or take a closer look at ordering
and outcomes.

Identified physicians must take HealthHelp’s research-based clinical examination within thirty days. Then they must go through RadCert’s™ preauthorization or RadConsult’s™ peer clinical assessment process for six months when ordering CT, PET, or MRI tests. The physicians are then tracked for another six months through a benchmarking and profiling program to ensure that the unnecessary ordering does not continue.