Diagnostic Imaging Benefit Management

HealthHelp’s programs can save payers up to 15 percent of their diagnostic imaging costs and reduce members’ exposure to unnecessary radiation.

HealthHelp developed its effective suite of programs by applying a collaborative approach to radiology benefit management through peer-to-peer physician consultation. These evidence-based programs address factors that inflate the cost of diagnostic imaging—from procedure ordering to patient education.

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
• Site™:  Facility Assessment and Data Warehousing
  Helps establish and enforce technical standards that ensure safety and quality among contracted providers
• Direct™:  Procedure Scheduling
  Steers services to inexpensive, accessible, and convenient in-network providers
• Alert™:  Referral Pattern Analysis and Modification
  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 create sustained savings when used individually but can achieve even greater cost reductions when integrated into custom implementations that incorporate HealthHelp’s diagnostic cardiology  and radiation oncology  capabilities.