HealthHelp

An approach to Utilization Management that has gained attention is Provider Gold Carding, where certain Physicians are exempted from prior authorization based on their history of high-quality, appropriate care. The purpose of Gold Carding is to streamline the approval process, reduce administrative expenses, provide faster patient care and decrease provider frustration while maintaining oversight on those with less consistent track records.    HealthHelp provides Gold Carding services to our Clients, having developed robust evaluation criteria and creating in depth monitoring systems. Gold Carding offers the potential of increased efficiencies and satisfaction, however it also comes with risks of Provider bias. The jury is still out if reduced oversight increases overutilization, but whether State law or organizational priorities, HealthHelp can provide a compliant Gold Carding component of any of our specialty benefit management programs. #utilizationmanagement

A heartfelt thank you to everyone who made #AHIP2024 truly memorable. We're honored to have been a part of this event, and we look forward to continuing the conversation in the days ahead. Together, we're shaping the future of healthcare for the better! #specialtybenefitsmanagement #healthhelp

Dawn breaks on the final day of #AHIP2024 A big shout out to everyone we have met during this extraordinary event. It was our pleasure! There is still time to stop by to meet the HealthHelp team and learn how we are innovating specialty benefits management for health plans. Booth #1827. #specialtybenefitsmanagement

#AHIP2024 Day 1 is underway! Don’t miss HealthHelp at booth 1827. Come see how our utilization management programs allow health plans to ensure appropriate care for members across several key clinical lines and lower overall cost per case wile reducing provider friction. With our suite of clinical solutions inculding Cardiology, radiology, oncology, musculoskeletal, sleep care and our NEW genetic testing program, your health plan could benefit from: • Up to a 30% reduction in spend by specialty • Overall 5:1 ROI or greater • Industry leading 60 NPS and 98% satisfaction rating from providers #utilizationmanagement #benefitsmanagement

Our business partner, InformedDNA, will be speaking at #AHIP2024 about critical developments in #biomarker mandates that have complicated Genetic Testing Utilization Management and what health plans can do to address this emerging challenge. This is an excellent opportunity to gain insights from industry leaders. Join HealthHelp and InformedDNA on Wednesday, June 12 at 10:40 am in Presentation Theater 2. #GeneticTesting #UtilizationManagement #BiomarkerLegislation #InformedDNA #HealthHelp

Countdown to #AHIP2024! The HealthHelp team can't wait to attend in Las Vegas alongside our partner in genomic expertise, InformedDNA. Looking for a comprehensive specialty benefits management partner? From June 11 - 13, you'll find us at booth 1827. Join us! https://bit.ly/4aGpuKe

Prior Authorization Exemptions: Exploring Better Alternatives to Gold Carding with HealthHelp’s Quality Performance Program Prior authorization is a critical component of healthcare delivery, but it can also be a source of frustration and inefficiency for providers, payers, and patients alike. How can we improve the prior authorization process and ensure that it aligns with the goals of quality care and cost containment? In this article, we explore how HealthHelp’s Quality Performance Program offers an innovative solution that leverages data-driven analytics, configurable criteria, and comprehensive support services to streamline the authorization process and promote adherence to clinical guidelines and best practices. Unlike traditional methods like gold carding, which rely on blanket approvals and lack transparency, our program enables a collaborative and evidence-based approach that optimizes patient outcomes and reduces unnecessary costs. If you are interested in optimizing your prior authorization process, we invite you to read the full article using the link below to learn more about how our solution can benefit your health plan: https://bit.ly/3ycvz3s #healthhelp #priorauthorization #goldcarding #healthcarequality

During National Nurses Week, HealthHelp wants to continue to express our gratitude to nurses for their unwavering dedication to patients. Thank you for being the heartbeat of our healthcare system. #Nurse #NationalNursesWeek #HealthHelp #WNS

Physical Therapy Benefits Management Physical Therapy (PT) is the first line, most conservative treatment for many conditions including osteoarthritis to mild-moderate injuries. It can help reduce pain, improve function, and sometimes avoid surgery or reverse injury altogether. To ensure PT and conservative therapies are maximized, HealthHelp offers a Physical Therapy Program that ensures your members receive the best care possible, while reducing costs and improving outcomes. Benefits of HealthHelp’s PT Program: Our Physical Therapy Program ensures conservative care is maximized and avoids unnecessary procedures that can cause harm to members. The progress and outcomes of members are monitored to ensure that they receive the appropriate level and duration of therapy. The HealthHelp clinical guidelines ensure that providers are implementing the standards of care consistently across all practices as it relates to the use of conservative therapy. The goal is to work with physicians so that PT is not misused or overused, but leveraged as a valuable tool to improve member health and well-being. Our managed PT program improves the quality of care for health plan members, by ensuring that the anticipated benefit of the recommended intervention outweighs the potential harm that may result. By managing PT effectively, we also reduce costs to the plan, and ultimately to your members. The net benefit is the avoidance of unnecessary or excessive therapy to prevent complications or surgeries that may result from untreated or poorly treated conditions. You can learn more about our managed PT program here: https://bit.ly/44oukdn #healthhelp #physicaltherapy #physicalmedicine #msk