Accurate, prompt diagnosis of heart disease saves lives. It can also save money.

 

But many patients don’t receive the right test the first time. The results? Redundant testing. Unnecessary cost and radiation exposure. Potential treatment delays.

 

HealthHelp has long applied its time-tested, collaborative specialty benefit management process to cardiac imaging modalities including CTA, MRA, and cardiac nuclear medicine. By adding diagnostic cardiac catheterization capabilities, HealthHelp now offers payers a robust suite of programs for ensuring quality, safety, and sustained savings in cardiology testing.

 

A broad range of diagnostic cardiology procedures, including catheterization, are managed through the following programs:

 

Programs

 

• Consult™:  Collaborative Specialty Benefit Management
  Lowers cost by putting the latest medical evidence at physicians’ fingertips—and peer experts a phone call away
• Cert™:  Consultative Preauthorization
  Builds physician knowledge through traditional precertification
• CodeRight™:   Claims Review
  Ensures correct payment of medical claims

 

HealthHelp’s other effective programs provide additional mechanisms for managing CTA, MRA, and cardiac nuclear medicine tests:

 

Programs

 

• Direct™:  Procedure Scheduling
  Steers services to inexpensive, accessible, and convenient in-network providers
• Site™:  Facility Assessment and Data Warehousing
  Helps establish and enforce technical standards that ensure safety and quality among contracted providers
• Alert™:  Referral Pattern Analysis and Adjustment
  Monitors physician ordering patterns
• Scope™:  Nonradiologist Ordering
  Reimbursement policies for nonradiology specialists
• Excell™:  Physician Education
  ACCME-accredited diagnostic imaging education program for nonradiology specialists
• Aware™:  Patient Education
  Reduces imaging exam volume by informing members about the risks, benefits, and reasons for common imaging procedures

 

These programs can complement payers’ existing radiology benefit management programs, or they can integrate with HealthHelp’s robust diagnostic imaging  and radiation oncology  capabilities.