Consultative Preauthorization

Managing Specialty Costs and Quality

HealthHelp’s consultative preauthorization program, Cert™, collaboratively builds physician knowledge while offering traditional precertification services for individual diagnostic imaging  and cardiology tests and for complete radiation oncology treatment plans.

Although it provides for denials and supports appeals, Cert’s long-term success results from changing ordering patterns by enhancing physician knowledge. Ordering physicians can use HealthHelp’s exclusive Medical Imaging Consultant to choose options that offer the greatest clinical value with the lowest risks. This helpful tool contains the latest evidence-based information arranged by clinical condition.

When exam requests and treatment plans don’t correlate with HealthHelp’s evidence-based guidelines, subspecialists with Thomas Jefferson University, the University of Washington, and other respected medical schools provide consultation. Reviews are completed within forty-eight hours.

HealthHelp supports appeals for its Cert clients by maintaining case information, providing peer-reviewed literature, and assisting payers in person or by phone.