Annual US Direct and Indirect Costs for Bone and Joint Health$
For the evaluation of:
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.
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.
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.
In all cases, some form of treatment will be approved.
The program covers the use of diagnostic procedures, invasive interventional procedures, PT/OT therapies, injectables, prostheses, and surgical implantable devices.
Non-Surgical Pain Management
Surgical Pain Management
Hip & Knee
Upper Extremity, Wrist, Femur, Tibia, Shoulder, Elbow, and Foot
*Lists not comprehensive