Musculoskeletal Care Management
Reduce low-value MSK imaging and procedures by aligning ordering with evidence-based pathways and keeping determinations fast and transparent.
Program Impact
0 %
Appropriate Imaging
0 %
Conservative Care Verified
0 %
Auto-Auth Pathways
0 %
Avoided Low-Value Tx
Guideline alignment over time
last 12 monthsAdherence across lumbar imaging, knee MRI, shoulder, and cervical spine pathways.
Snapshot
- Median decision time18m
- Peer-to-peer within 2h97%
- Avoided unnecessary MRIs-21%
- Rework rate↓ 28%
Modules
Guideline Engine
ACR/AAOS-aligned criteria mapped to payer policy and local pathways.
Conservative Care
PT-first pathways, trial documentation, and outcome checks.
Auto-Auth
Deterministic rules + ML triage for clear cases.
Peer Review
Rapid subspecialty review and same-day P2P.
Member Safety
Duplicate imaging detection and escalation when needed.
Insights
Ordering patterns, appropriateness, and TAT transparency.
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