Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

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Merge imaging solutions help one practice establish lean, mean radiology process

Sponsored by Merge, an IBM company

Radiology has been hit hard by reimbursement cuts and regulations but the cutting-edge tools available are helping practices stay ahead of all the changes impacting the market.

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Medicare Overpayment Refunds in the Spotlight

The practice has identified a billing error or a compliance problem impacting Medicare coverage that resulted in the practice having received an overpayment from Medicare.

ICD-10 attitudes survey validates official delay

Just before the transition to ICD-10 was officially delayed, NueMD conducted a survey of 1,300 healthcare professionals to gauge their attitudes towards ICD-10.

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Effects of the Most Recent Reimbursement Cuts to Diagnostic Imaging

VMG

The ever changing landscape of outpatient diagnostic imaging is compelling operators to have a keen understanding of market conditions in order to appropriately assess the potential return on investment on capital investments to upgrade or replace major imaging equipment. 

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The Knowns and the Unknowns

What do we really know? As former Defense Secretary Donald Rumsfeld once said: “We know there are known knowns; there are things we know we know.

Deadline Looms for “High Risk” Enrollees

According to an article in the Wall Street Journal, there is a significant segment of high risk individuals with pre-existing medical conditions currently enrolled in a federal health insurance program that is slated to close on March 31, 2014. This federal program was created shortly after the 2010 health law was passed to offer assistance to those people who couldn’t get coverage from commercial insurers because of their pre-existing medical conditions. There was $5 billion in funding set aside to cover this group’s medical claims through December 31, 2013. 

Feds Seize Records in Zwanger-Pesiri Medicare Probe

According to an article published in NewsDay, Federal agents raided the corporate headquarters of Zwanger-Pesiri Radiology in Lindenhurst on Tuesday, March 11, seizing the records of the business that operates 12 medical offices on Long Island, NY. 

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Getting Down to Business

Healthcare providers are rolling up their sleeves even further and getting down to the business of healthcare. With the final CMS reimbursement decisions made last month and open enrollment in the health insurance exchanges (HIEs) and Medicaid closing next month, there are new data impacting radiology practices. For sure, lower contracted rates from payors and lower reimbursement are on the way—for an extremely large patient population. Radiology departments and practices need to revisit the efficiency of their operations.

Around the web

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

The all-in-one Omni Legend PET/CT scanner is now being manufactured in a new production facility in Waukesha, Wisconsin.

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