Outpatient Echocardiography/Coronary Angioplasty/Stent

Review of outpatient transthoracic echocardiogram (TTE) and outpatient coronary angioplasty/stent procedures is administered by HealthHelp®, a radiology benefit management organization. Please note that prior authorization, precertification, preadmission and preauthorization requirements are all used to refer to the preauthorization process.

Preauthorization and notification for outpatient transthoracic echocardiogram (TTE) and outpatient coronary angioplasty/stent procedures

Humana uses HealthHelp’s RadConsultTM tool for obtaining preauthorization for Humana-covered patients' outpatient transthoracic echocardiogram (TTE) and outpatient coronary angioplasty/stent procedures.

Please note: Exclusions from this requirement include the following members and providers:

  • Puerto Rico commercial, Medicaid and MA members and their providers
  • Florida MA HMO and Medicaid HMO members and their providers
  • Ochsner commercial and MA HMO members and their providers
  • Health Care Partners commercial and MA HMO members and their providers
  • Chicago risk and delegated providers

Submitting Preauthorization Requests

Humana requires that preauthorization requests for outpatient transthoracic echocardiogram (TTE) and outpatient coronary angioplasty/stent procedures be submitted to Humana Radiology Services by calling 1-866-825-1550, available 7 a.m. to 7 p.m. Central time, Monday through Friday, and 9 a.m. to 4 p.m. Saturday, or by submitting an online request via the HealthHelp website at HealthHelp. New enrollees should choose “Enroll” under "RadConsult™" to register.

As health care providers move through the authorization process, they will be prompted to provide the following information:

  • Member name and Humana member ID number
  • Ordering physician name
  • Ordering physician telephone and fax numbers
  • Patient diagnoses or clinical indication [International Classification of Diseases, Ninth Revision (ICD-9) code]
  • Procedure ordered (e.g., transthoracic, stress, dobutamine and intravascular echocardiogram; coronary balloon angioplasty or stent)
  • Clinical information supporting procedure request (e.g., presenting symptoms, prior treatment, prior diagnostic testing result, etc.)

Following assessment, an authorization number will be provided, or the health care provider will be contacted for clarification if the information is incomplete or does not meet evidence-based criteria for the procedure requested. HealthHelp will also offer assistance with locating an imaging facility.

HealthHelp

Phone: 1-866-825-1550

Available 7 a.m. to 7 p.m. Central time, Monday through Friday; 9 a.m. to 4 p.m. Saturday

Submitting a request online

Physicians may submit an online request via HealthHelp.

Additional Resources

Humana Cardiology Benefit Management

Learn more about this program and the patient information required when requesting preauthorization or providing notification.

RadConsult Presentation

Learn how to request, schedule and follow up on imaging services and treatment plans for your Humana-covered patients online with RadConsult by viewing the Education-on-Demand presentation, RadConsult Online.

Questions

Questions about this program may be directed to HealthHelp/RadConsult program support:

Phone: 1-800-546-7092

Available 7 a.m. to 7 p.m. Central time, Monday through Friday; 9 a.m. to 4 p.m., Saturday

Email: rcsupport@healthhelp.com