Cardiology Utilization and Quality Management

CareCore Cardiology offers health plans a comprehensive solution to effectively manage cardiologic services.

• Evaluating requests against nationally accepted evidence-based cardiology criteria
• Determining the most appropriate procedure by integrating previous imaging results and clinical history
• Avoiding unnecessary duplication of procedures and appropriately managing utilization
• Privileging clinical providers and sites for requested procedures

CareCore Cardiology provides a comprehensive set of criteria to manage echocardiography, nuclear and echo stress tests, coronary CT angiography, diagnostic left heart catheterizations, and implantable cardiac defibrillators and pacemakers.

Our services include:

• Authorization
• Performance Reporting and Benchmarking
• Privileging
• Payment Policies
• Network Management

Quality Management

Our approach to quality management enables our client’s to manage cardiology expenses within the parameters of its existing contracted provider network.

The Quality Management Program assures continual performance monitoring of the delivery system through the application of a dynamic set of quality based protocols to all facets of the delivery of care.

Our Equipment Certification Committee establishes quality standards used to credential facilities that perform highly specialized imaging exams such as computerized tomography angiography (CTA), echocardiography, and cardiac spect nuclear imaging.