OptiNet is an online assessment tool developed by Carelon Medical Benefits Management to collect modality-specific data from imaging providers. This tool is an enhancement to our Advanced Imaging Utilization Management program, which Carelon administers for Blue Cross and Blue Shield of Montana.
The OptiNet assessment process facilitates the provision of accurate and consistent information, when needed, to help promote patient safety, accessibility of care and cost effectiveness. The information on OptiNet is based on data given by high- and low-tech imaging service providers. Areas of assessment include staff qualifications and equipment accreditation. You can update your information whenever necessary.
High-tech imaging service providers
If you bill us for the technical component of computed tomography, magnetic resonance imaging, nuclear cardiology or positron emission tomography, you should already have completed Carelon’s online OptiNet assessment.
- Your assessment data will be analyzed to determine a modality score (represented by a letter grade) for each modality you register.
- High-tech service provider modality scores are available now to ordering providers via Carelon’s online directory.
- Your assessment will have the average allowed payment amount for the procedure (based on professional and technical components of previously billed services), along with distance from the member’s home (typically 30 miles). This data can help ordering physicians make health care decisions.
Low-tech imaging service providers
The OptiNet tool is available to collect capability information from providers who perform the technical component of echocardiography services.
- Your assessment data will be analyzed to determine a score (represented by a letter grade) for each modality you register.
- Low-tech provider modality scores will not be made available for viewing by ordering providers.
- We will use the results for reporting and quality enhancement initiatives.
Ready to begin?
- Register for OptiNet online.
- Select “BCBSMT” from the dropdown menu and complete the online assessment.
- You can save your data as you go. There’s no need to complete the assessment in one sitting.
- Upon completion, you’ll receive an email confirmation.
You can log in to OptiNet to update your information as needed.
Carelon Medical Benefits Management is an independent company that has contracted with BCBSMT to provide utilization management services for members with coverage through BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products or services they offer.