Outpatient CT, MRI, PET or other diagnostic imaging procedure

Important Radiology Process Change

Effective December 1st, 2010, we have implemented a diagnostic imaging ordering program, RadConsult™, for the following types of procedures: CT, CTA, MRI, MRA, cardiac nuclear medicine, and PET.

RadConsult™ is a quality evaluation program for outpatient and office-based advanced diagnostic imaging procedures.  The program is designed to improve health care, patient safety, utilization, and cost through the application of clinical criteria when ordering advanced imaging procedures.  This program will NOT affect Emergency Department services or those services ordered while a member is hospitalized.  The program will apply to all American Family customers who do NOT utilize GWH-CIGNA as their Preferred Provider Organization (PPO) network.

All requests for CT, CTA, MRI, MRA, cardiac nuclear medicine, and PET, will go through HealthHelp, and their program RadConsult™.  Please contact HealthHelp using one of the following to obtain quality reference numbers for high-technology imaging procedures:   

What is RadConsult™
RadConsult™ is a consultative, educational program that improves quality and reduces the cost of care by providing expert peer consultation and the latest evidence-based medical criteria for diagnostic imaging.  It gives you access to consultations with subspecialists affiliated with leading academic radiology departments.  RadConsult™ does NOT issue denials for services requested; but if the requested service does not meet guidelines, a HealthHelp Radiologist will have a Provider to Provider with the requesting physician to consider alternatives.

What this means to you
If you are ordering a CT, CTA, MRI, MRA, cardiac nuclear medicine, or PET procedure, you or your office staff are asked to submit the request using a web-based ordering system, phone, or fax.  Requests will be reviewed against guidelines, and a quality reference number will be issued.  HealthHelp does not pre-authorize (if applicable), pre-certify or otherwise approve of or validate the eligibility of any procedures submitted to HealthHelp.

Confirm Your Procedure Request
If you also provide in-office radiology imaging for any of the listed procedures/tests above, you are asked to confirm that RadConsult™ has processed the procedure request before scheduling an appointment.

Using a secure login, you may access WebConsult to check the status of procedure request.

Thank you for helping us facilitate access to the right tests at the right times to enhance timely diagnosis and treatment of every member, every time.  We appreciate your involvement with this significant new program.  If you have questions regarding this program, or would like additional information, please contact HealthHelp at 800.405.4817 ext 1751