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

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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

Your providers submit requests to us online or over the phone.

Our automated platform reviews requests in real time.

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. 

We redirect imaging services to high-value sites of care, when clinically appropriate. (Optional)

Request data is shared with your system(s) for claims, care management, and/or reporting purposes.

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.