Cardiovascular Solution
Enhance your members’ cardiovascular care
Our Cardiovascular Solution delivers advanced cardiology and vascular benefit management to help your health plan members receive high-quality, more affordable, optimized 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, such as echocardiography, to percutaneous coronary treatments, vascular interventions, 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 you address these challenges by supporting appropriate care, strengthening provider decision-making, and helping to make cardiovascular care more sustainable.
Protect your members from unnecessary procedures
We help ensure your members aren’t exposed to the risks of unnecessary cardiology and vascular 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 lower-cost settings, we create double-digit savings on the care we manage for health plans.
What’s included in our Cardiovascular Solution
Effective, affordable cardiovascular care in the right setting follows medical best practices. Our solution blends automation with human-to-human interaction to help support that care.
Clinical appropriateness review
Network management
Practice engagement resources
Enhanced review (optional)
Advanced analytics and reporting
How cardiovascular management and utilization review works
Request
Your providers submit requests to us online or by phone.
Review
Our automated platform reviews requests in real time against applicable clinical criteria.
Determine
Requests that meet clinical criteria can be approved immediately. When additional review is needed, our clinical reviewers, including board-certified cardiologists and nurses, are available to consult with your providers about requests that don’t meet our clinical criteria or the health plan’s medical policy.
Redirect
When clinically appropriate, we can redirect imaging services to high-value sites of care. This capability is optional.
Synchronize
We share request data with your system(s) for claims, care management, or reporting purposes, as applicable.
Ready for the next step?
Connect with us to explore the potential impact of our Cardiovascular Solution for your health plan.
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Frequently asked questions about cardiovascular solutions
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 member ID card.
Provider inquiries: For questions about a request or the Provider Portal: Call 800-252-2021 or contact our support team .
Business hours: 8 a.m. to 5 p.m. CT.