History

CareCore National, a specialty benefit management company, manages quality and utilization of outpatient diagnostic and cardiac imaging, cardiac implantable devices, oncology drugs and therapeutic agents, radiation therapy, sleep, pain and lab services. With a comprehensive and diverse portfolio of offerings, we provide seamless solutions to health plans that seek to manage these specialty health care segments more effectively.

Our Focus
CareCore National provides physicians with access to the latest evidence-based criteria and works collaboratively with providers to improve the way care is delivered to patients. We focus on appropriateness to ensure that health plan members receive the right procedure for their clinical situation. We achieve this by employing state-of-the-art technology and evidence-based criteria. All CareCore National programs improve quality, streamline patient care and reduce cost.

Our History
CareCore National was founded in 1994 to provide comprehensive, customized programs to health plan clients that seek to improve utilization of diagnostic imaging and enhance the quality of care delivered to its members. CareCore National’s innovative and quality-driven approach to radiology utilization management has made it the country’s fastest-growing outpatient diagnostic imaging utilization management services provider.

Building on our success, CareCore National expanded its offering to include two highly specialized areas of specialty care: cardiology and oncology. In 2005, CareCore National launched CareCore Cardiology to provide value-added management of cardiac benefits, which covers management of cardiac imaging and implantable devices. In 2007, CareCore National launched CareCore Oncology to provide specialized management of oncology drugs and therapeutic agents. In 2008, CareCore National added to its portfolio management programs for sleep apnea, pain management and lab services, which include high-cost genome testing.

CareCore National currently manages more than 30 million lives. Our clients include some of America’s most well-known, trusted health plans.

We place high value in working hard, being innovative, committing to excellence, and providing clients with the best management services available.