Radiology Benefit Management Information

Effective February 1, 2016, the MO HealthNet Division (MHD) changed the Radiology Benefit Management (RBM) program from EviCore/MedSolutions to HealthHelp. HealthHelp, a nationally known RBM provider, is implementing a program designed to improve health care, participant safety, utilization, and cost through the application of clinical criteria.

The RBM program encourages the use of evidence-based, quality imaging practices and will continue to precertify high-tech and cardiac imaging procedure codes. HealthHelp will require all imaging equipment to be certified. Refer to the Radiology bulletin for specific information regarding the certification.

All precertification requests must be initiated by an enrolled MO HealthNet provider. Requests for precertification may be made by using the web tool, Cyber Access, or by calling the MO HealthNet Call Center at (800) 392-8030, option 5.

Please visit the HealthHelp web page for more information on precertifications through HealthHelp.