Mary* is a 60-year-old patient who has been experiencing balance issues. She has fallen several times. Her doctor identifies an abnormal walking pattern.
Mary's doctor orders a head CT scan without contrast.
Diagnosing Mary
Once the brain MRI is approved, EviCore solutions, including the SmartChoice, Site of Care, and preventive care outreach programs, are available to increase access, contain cost and improve patient outcomes.
Making the right call
Achieving better outcomes
Our physicians connect with Mary’s doctor to make an alternative recommendation for a brain MRI and explain why it is a better study that will be necessary regardless of any CT scan results. This outreach avoids a delay in care.
Peer-to-peer support in action
Based on Mary’s symptoms, our board-certified physicians use EviCore's evidence-based criteria to determine that a brain MRI with and without contrast is the best imaging study for Mary’s health issues. The MRI is superior because it shows a better view of parts of the brain, helping to both diagnose the problem and start the right treatment sooner.
Mary’s doctor agrees with and accepts EviCore’s alternative recommendation.
Our Site of Care program will ensure that Mary receives the MRI at the accredited facility that is most convenient and of lowest cost for her.
Our Preventive Care outreach experts will ensure Mary is enrolled in any preventive care programs she may be eligible for based on her clinical history.
Finally, our SmartChoice program will facilitate communication with Mary, including helping her schedule her appointment, providing her with patient education she may benefit from and following up to ensure her exam was completed to fill any existing gaps in care
MRI is the study of choice for this patient’s condition because it offers clearer pictures of the brain. MRI is more costly, but it will expedite diagnosis and treatment plan development. It may also eliminate the need for multiple studies (CT + MRI), which ultimately is more costly in time as well as money for patients.
HOW DOES THAT WORK?
WHAT HAPPENS NEXT?
Clinical review
EviCore ensures procedures are in accordance with the most up-to-date literature and national guidelines to promote the most clinically appropriate and cost-effective care for each patient.
As a result, Mary will undergo the best study for her condition and avoid any radiation exposure.
A peer-to-peer discussion enables a patient’s physician to discuss a complex case with an EviCore medical director with experience in the same specialty. During a P2P, the doctors discuss how the clinical guidelines apply in these particular circumstances.
Peer-to-Peer (P2P) Discussion
*Not patient’s real name. Images are for illustration purposes only.
IS THIS THE PROPER IMAGING?
The result: Better health outcomes and lower costs for everyone.
Learn more at
EviCore.com
or email us at
MSK@evicore.com.
Meet Mary
