HealthHelp increases patient safety by reducing radiation exposure and provides savings by improving overall quality of care for over 8 million members.

Annual Cost of Medical Imaging in the US


Radiology Program Overview

  • More than 20% immediate savings impact over unmanaged population.
  • Sustainable, long-term cost savings.
  • Lasting education and provider ordering optimization.
  • Radiology facility certification with RadSite’s stringent criteria.
  • Management of provider self-referral behavior.
  • Improved imaging quality and interpretation by ensuring that specialized and trained physicians perform consults.
  • Patient education on safety, quality, and costs to simplify facility and physician choices.

Radiology ConsultThe Right Procedure at the Right Place at the Right Time

Patient Clinical Information*

  • Patient Diagnosis
  • Clinical Indication
  • Treatment Requested
  • Reason for Test
  • Patient Symptoms and Duration
  • Laboratory Studies
  • Patient Medications and Duration
  • Prior Treatments
  • Summary of Clinical Findings
  • Automated Decision Support

    Providers submit procedure requests. If the treatment meets evidence-based criteria, it is automatically approved.


    If the treatment falls outside of pre-set clinical guidelines, it is sent to nurse review.

    Specialty Nurse Consult

    HealthHelp nurses evaluate requests and provide approvals for treatments within clinical guidelines. For procedures that fall outside of these criteria, nurses will discuss an alternative care pathway.


    If consensus is not reached, the request is sent for a peer-to-peer consultation.

    Peer-to-Peer Consultation

    A HealthHelp physician reviews the treatment. After consultation with the requesting provider, the procedure will either be changed, not performed, or agreement will not be reached.

Medically Appropriate Procedures*

  • CT
  • CTA
  • CT Bone Density
  • Interventional Radiology
  • MRA
  • MRI
  • MRS
  • fMRI
  • Nuclear Medicine
  • PET Scan
  • Doppler
  • Ultrasound
  • 3D Mammography

*Lists not comprehensive

Contact Us
Questions? Contact us to find out how our programs can create savings for you.
Please note: If you are communicating as a health plan member, please contact your healthcare provider. HealthHelp does not provide individual healthcare advice.