Quality of Care

Across all of Medical Helpline's programs, our Registered Nurses and Advocates strive to help patients obtain appropriate and quality care, while maintaining control over costs. Our services generate quantifiable improvements in care and savings to both the patient and health plan. Our highly-specialized team determines medical necessity, location of care and appropriateness of Inpatient and Outpatient Medical, Psychiatric and Substance Abuse admissions/procedures using clinical experience and health care standards.

Importance of Quality Care

"You get what you pay for" does not apply to health care. Unlike other markets, paying more for health care services rarely result in higher quality. For example, facilities with the highest costs for medical services may provide low quality care, and, conversely, high-quality facilities may charge the lowest fees for care. High costs of care can also be driven by the results of poor quality care, such as hospital re-admissions, preventable infections, and complications resulting from poor chronic-condition management.

Medical Helpline Advocates Help Members Find Quality Care 

Medical Helpline Advocates help patients find high quality providers and facilities using Healthcare Bluebook. Our Healthcare Bluebook site was jointly developed by Medical Helpline and Healthcare Bluebook to help members easily find quality providers and facilities at a reasonable cost.