HealthHelp's Consult platform ensures rapid response to authorization requests through a consultative and decision support process.

Consults Processed to Date

MILLION Source


Consult Platform Provides:

  • Web-based workflow processing of Consult requests.
  • Multiple service points to meet client and provider needs: Web, Fax, Phone, IVR, EDI.
  • Less than 30 seconds average response time on inbound phone requests.
  • Automatic escalation to nurses and physician specialists as clinically warranted.
  • Case processing within each state’s specific turnaround time guidelines.
  • Complete HIPAA Privacy & Security compliance.
  • Full URAC and NCQA compliance.
  • Web and IVR allow self-service procedure initiation and status checks.

Collaborative Care ManagementThe Right Procedure at the Right Place at the Right Time

Patient, Provider, and Payor Collaboration

Patient Collaboration

  • Patient advocacy
  • Direction of patients to right care
  • Reduction of unnecessary and inappropriate procedures
  • Reduction of radiation exposure

Provider Collaboration

  • Peer-to-peer model without denials, embraced by physicians
  • Clinical education and support
  • Documentation of managed risk evidence for procedures helps providers
  • Minimization of potential lawsuits

Payor Collaboration

  • Lower spend by managing utilization
  • Inclusion in 85% of MLR improves profitability
  • Creation of an optimized provider network
  • No hard denials mitigates legal risk

Sustainable and Long-Term Utilization Behavior Reform

 

  • Observable and measurable ordering behavior change
  • Sustainable utilization management and savings
  • Demonstrated return on investment for payors
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.