Cardiovascular Solution
Enhance your members’ cardiovascular care
Our Cardiovascular Solution helps your health plan members receive high-quality, more affordable care. To do this, we promote evidence-based cardiovascular care to your providers so your health plan can better manage highly utilized, expensive imaging tests and interventions. These can range from implantable cardiac devices to imaging, like echocardiography, percutaneous coronary treatments, and more.
Lines of business
• Commercial
• Medicare
• Medicaid
• Federal employee
Make an immediate impact on cardiovascular care
The complexity and costs of cardiovascular disease are a rising challenge for nearly every health plan today. Our solution helps ensure your members receive optimal, evidence-based care for highly utilized imaging tests and interventions.
Protect your members from unnecessary procedures
We make sure your members aren’t exposed to the risks of unnecessary procedures — or their costs.
Help your providers focus on clinical excellence
We help cardiologists put best practices into practice. Our solution equips your providers with the latest proven clinical criteria so they can focus on delivering evidence-based cardiovascular care.
Gain savings by reducing ungrounded care
By eliminating unnecessary cardiovascular tests and treatment and guiding members to more affordable settings, we create double-digit savings on the care we manage for health plans.
Inside our Cardiovascular Solution
Effective, affordable cardiovascular care in the right setting follows medical best practices. Our solution blends automation with human-to-human interaction so it can.
Clinical appropriateness review
Clinical setting optimization (optional)
Practice engagement resources
Member engagement (optional)
Advanced analytics and reporting
Clinical appropriateness review
Network management
Practice engagement resources
Enhanced review (optional)
Advanced analytics and reporting
How our solution works
Request
Your providers submit requests to us online or over the phone.
Review
Our automated platform reviews requests in real time.
Determine
Requests meeting clinical criteria are immediately approved. Our clinical reviewers, including board-certified cardiologists and nurses, are available to consult with your providers about any requests that don’t meet our clinical criteria and/or health plan medical policy.
Redirect
We redirect imaging services to high-value sites of care, when clinically appropriate. (Optional)
Synchronize
Request data is shared with your system(s) for claims, care management, and/or reporting purposes.
Explore related solutions
Ask us about our Cardiovascular Solution
Health plan leaders, contact us to learn more about the possibilities and impact of our Cardiovascular Solution.
Are you a health plan member?
If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.
Provider inquiries
For questions about a request or the Provider Portal: Call 1-800-252-2021 or contact our support team
Business hours: 8:00 a.m. – 5:00 p.m. CST.
