Radiation Oncology Solution
Keep the focus on evidence-based care
Our Radiation Oncology Solution helps create value for your health plan by guiding your members with cancer to clinically appropriate radiation therapy. We partner with your providers to ensure your members’ radiation plans, including fractionation and use of image guidance, are backed by medical evidence to meet their individual needs.
Lines of business
• Commercial
• Medicare
• Medicaid
• Federal employee
Imagine clinically optimal radiation therapy at scale
Assessing the value of radiation for your members is a complex, time-consuming job for health plans. We help streamline it. We connect our clinical expertise with our frictionless technology to ensure that clinical integrity drives the use of radiation therapy. And that benefits the entire healthcare system in your market.
Help shield your members from unnecessary harm
Excessive radiation poses serious health risks to your members. We help your health plan protect against that. With our solution’s clinical guidelines, your health plan can ensure your members undergo optimal radiation therapy backed by medical evidence.
Help your providers focus on evidence, not buzz
Hype around new radiation therapy technologies is constant. Tracking the latest research requires time providers don’t have. We help make the optimal decisions clearer for your providers. With our solution, your providers get side-by-side training on the latest guidelines and decision support when they need it most.
Free up your clinical operations’ bandwidth
Providers aren’t the only ones struggling to keep up with radiation oncology research. Leading health plans are too. We’re their strategic partner for that challenge. With our Radiation Oncology Solution, your health plan leverages our expertise, rather than your resources, to stay current on the specialty’s rapidly evolving best practices.
Inside our Radiation Oncology Solution
Radiation oncology continues to pose risk to health plans. Billing remains complex. Unnecessary use of technologies like IGRT is common. And fractionation often isn’t optimized. We designed our solution to manage trends just like these.
Clinical appropriateness review
Alignment with value-based payment models (optional)
Dedicated practice engagement team
Early palliative care referral support (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 the requests in real time.
Determine
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including board-certified radiation oncologists and nurses, are available to consult with your providers about any requests that don’t meet our clinical guidelines.
Synchronize
Request data is shared with your system(s) for claims, care management, and/or reporting purposes.
Explore related solutions
Ask us about our Radiation Oncology Solution
Health plan leaders, contact us to learn more about the possibilities and impact of our Radiation Oncology 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.
