The International Regulatory Affairs Network
09.03.2010
HealthHelp Enhances Diagnostic Cardiology Services
HealthHelp, a leading specialty benefit management provider, continues to target health care cost drivers by adding diagnostic cardiac catheterization to its well-established and effective suite of services.
HealthHelp, a leading specialty benefit management provider, continues to target health care cost drivers by adding diagnostic cardiac catheterization to its well-established and effective suite of services.
"As economic and regulatory trends pressure the health care industry to rein in rising expenses, HealthHelp diligently explores ways we can apply our collaborative model to specialties that account for large percentages of that cost," explained HealthHelp president and CEO Cherrill Farnsworth. "Our approach promotes quality and safety by enhancing physician knowledge of appropriate testing and treatment, which leads to long-term, sustained cost savings. With the radiation oncology capabilities we rolled out nationally last year—and now diagnostic cardiac catheterization—we offer payers a comprehensive package."
HealthHelp's approach reduces redundant testing, physician self-referral, and the practice of defensive medicine. Its consultative platform helps ensure that health plan members receive prompt, accurate cardiology diagnoses by giving physicians the evidence-based information they need to order the most appropriate tests at the right times.
HealthHelp's radiology benefit management programs already manage utilization and cost for CTA, MRA, PET, and cardiac nuclear medicine provided in the outpatient setting. The addition of diagnostic cardiac catheterization broadens the scope of its effective programs. HealthHelp's clinical criteria for cardiology are based on American College of Cardiology guidelines and the latest peer-reviewed literature.
Heading the clinical team for the new service is Anthony DeFrance, M.D., HealthHelp's medical director for cardiology. Dr. DeFrance will lead a team of board-certified cardiologists, who will provide expert consultation to ordering physicians when needed. Dr. DeFrance is board certified in cardiology and interventional radiology. He also serves as cardiology fellowship director for cardiac CT at California Pacific Medical Center and as medical director for CVCTA Education Center, both in San Francisco.
"Cardiovascular disease remains the leading cause of death in the United States, so our health care system justifiably devotes vast resources to early diagnosis," Dr. DeFrance said. "But performing the wrong kinds of tests not only wastes money, it potentially delays life-saving treatment. I look forward to helping provide physicians with the latest medical evidence and peer-to-peer consultation they need to order the right tests at the first time."
HealthHelp has incorporated diagnostic cardiology services into its pioneering benefit management and precertification programs. In addition, cardiology and interventional radiology codes are built into its automated claims review program, which offers a real-time option.
These programs can complement payers' existing benefit management programs, or they can integrate with HealthHelp's robust diagnostic imaging and radiation oncology management capabilities. Ordering physicians follow the same process and work through the same contact center they currently use to submit imaging exam orders and radiation oncology treatment plans for review.
About HealthHelp®
HealthHelp, a leader in specialty benefit management, generates significant savings and return on investment for health care payers by enhancing physician knowledge, improving quality of care, and reducing unnecessary radiation exposure. Each of its programs addresses a different aspect of diagnostic imaging, cardiology, and radiation oncology. The clients of Houston-based HealthHelp administer local, statewide, and national health care plans across the country. For more information about HealthHelp's programs, visit www.healthhelp.com.
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