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.

Konica Minolta and ImagineSoftware partner to expand revenue cycle management offerings
Konica Minolta partnered with ImagineSoftware to integrate its AI-driven revenue cycle management platform into the Exa PACS-RIS solution.
Shift toward imaging outside the hospital could save billions
Harvard’s David A. Rosman, MD, MBA, explains how moving imaging outside of hospitals could save billions of dollars for U.S. healthcare.
ACR shares guidance to help members deal with confusing White House executive orders
A string of executive orders from the White House created serious concerns among radiologists and other healthcare providers throughout the United States. The American College of Radiology issued a statement to help guide its members through the chaos.
Concerns about private equity's growing influence in radiology
Melissa Davis, MD, vice chair of medical informatics and associate professor at Yale University’s Department of Radiology and Biomedical Imaging, shares her findings from research on private equity market penetration.
Reimbursement update: What hospitals need to know about new Medicare payments for cardiac CT
CMS finalized a significant policy change when it increased the Medicare payments hospitals receive for performing CCTA exams. What, exactly, does the update mean for cardiologists, billing specialists and other hospital employees?

Top trends in cardiac CT from SCCT 2023

Cardiac CT has been evolving rapidly in recent years. Brian Ghoshhajra, MD, outlined some of the main trends he has seen at the 2023 annual meeting of the Society of Cardiovascular Computed Tomography.

Kumar Aditya, director, information technology, Atlantic Health System, explains how the system automated more than 60% of its radiology prior authorization workflow.

How Atlantic Health automated its radiology prior authorization workflow

Director of IT Kumar Aditya explains how the New Jersey hospital system automated more than 60% of its radiology prior authorization workflow.

Private-payer billings not radiology’s revenue category to lead

Going by claims submitted to commercial insurers, radiology ranks 15th out of 18 physician specialties.

The integration of artificial intelligence (AI) into radiology PACS and enterprise imaging systems has become a big topic of discussion with IT vendors over the past couple years. This has become a bigger question from hospitals and radiology groups as there are now about 400 radiology related AI algorithms that have U.S. Food and Drug Administration (FDA) clearance. Amy Thompson, a senior analyst at Signify Research, is monitoring AI trends in radiology and discusses trends.

Trends in the adoption and integration of AI into radiology workflows

Amy Thompson, a senior analyst at Signify Research, explains why AI adoption has been slow in radiology, common barriers and trends in the market.

VIDEO: Impact of the 2023 Medicare cuts on radiology

Ed Gaines, JD, vice president of regulatory affairs and industry liaison, Zotec Partners, discussed the impact of the 2023 Medicare Fee Schedule on radiology at RSNA 2022 in Chicago last week. RSNA and several other medical societies say the cuts are not sustainable.

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the No Surprises Act on radiology at the Radiological Society of North America (RSNA) 2022 meeting. Gaines works with RSNA on billing and Medicare issues and spoke in sessions at the RSNA 2022 meeting. Insurance companies have weaponized the No Surprises Act in an effort to cut their costs, he said.

VIDEO: Insurance companies have weaponized the No Surprises Act, may impact patient care

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the impact of the No Surprises Act on healthcare and medical imaging at the RSNA 2022 meeting

Providers face ‘ominous reality’ of payment cuts as CMS finalizes 2023 Physician Fee Schedule

Physicians are now bracing for payment cuts after the Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Physician Fee Schedule.

Example of the four types of breast tissue density. The density of fibroglandular tissue inside the breast impacts the ability to easily see cancers. Cancers are very easy to spot in fatty breasts, but are almost impossible to find in extremely dense breasts. These examples show craniocaudal mammogram findings characterized as almost entirely fatty (far left), scattered areas of fibroglandular density (second from left), heterogeneously dense (second from right), and extremely dense (far right). RSNA

Breast density notification laws blanket 90% of U.S. women, yet still no national reporting standard is at hand. Why is that?

Dense breast experts Wendie Berg, MD, and JoAnn Pushkin, executive director of DenseBreast-info Inc., explain the current status of breast density patient inform laws, reimbursement and new technologies to aid cancer detection.

Around the web

Health Imaging

American College of Radiology announces significant expansion of Lung Cancer Screening Registry

The ACR hopes these changes, including the addition of diagnostic performance feedback, will help reduce the number of patients with incidental nodules lost to follow-up each year.

Health Imaging

AI reduces CT lung cancer screening workload by nearly 80%

And it can do so with almost 100% accuracy as a first reader, according to a new large-scale analysis.

Health Imaging

Nearly $800,000 settlement offered to family of man who died during MRI exam

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

Revenue & Reimbursement

Konica Minolta and ImagineSoftware partner to expand revenue cycle management offerings

Shift toward imaging outside the hospital could save billions

ACR shares guidance to help members deal with confusing White House executive orders

Concerns about private equity's growing influence in radiology

Reimbursement update: What hospitals need to know about new Medicare payments for cardiac CT

Around the web