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Care to Care's User-Friendly Prior Authorization Process Reduces Misutilization Rates

Care to Care took special notice of the recently published paper by Walmart and Covera Health studying the economic impact of misdiagnosis of imaging procedures. According to Lisa Woods, Senior Director of Benefit Design for Walmart, the key issue is that the interpretations of the diagnostic imaging their employees were receiving, including CT scans and MRI exams, had high error rates.    

While it is difficult to truly ascertain the diagnostic imaging and image interpretation error rates, there are a multitude of challenges that can be resolved. Care to Care targets these issues at the start of the problem by minimizing the number of inappropriate advanced imaging studies performed. We strongly believe in a user-friendly prior authorization process for advanced imaging to reduce the misutilization rates. By eliminating unnecessary imaging studies, we save not only the wasted time, expense, and radiation inherent in that exam, but also any further testing or procedures that might result from the report of that test.

We also believe that using free-standing facilities that are accredited by the American College of Radiology (ACR) supports quality outcomes, as such all of the facilities in our network are ACR accredited and fully credentialed. Care to Care programs focus on value based care and patient safety while minimizing waste and resulting in reduced cost to payors, like Walmart as well as their employees. Savings are also realized through Care to Care’s multi-pronged compliance initiatives that prevent fines imposed by regulatory bodies.

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“We at Care to Care understand that success is reliant on collaboration of all stakeholders and as such, we work closely with payors, regulators, clinicians, and members to achieve this goal,” said Barbara Kelman, Chief Operating Officer at Care to Care.

Care to Care is a URAC Accredited Specialty Benefit Utilization Management company that delivers evidence-based, physician-friendly solutions to ensure payers and their beneficiaries receive cost-effective care by reducing redundant or unnecessary imaging studies. Care to Care, LLC provides Utilization and Network management to government, commercial, and self-funded programs. For more information, visit

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