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.

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

VIDEO: AMA will ask Congress to revise clinical decision support mandate for cardiac imaging

American Society of Nuclear Cardiology (ASNC) delegates to the American Medical Association (AMA) House of Delegates 2022 meeting Stephen Bloom, MD, and Nishant Shah, MD, explain a new AMA policy asking Congress to revise its clinician decision support mandate. 

June 22, 2022
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PHOTO GALLERY from AMA House of Delegates 2022 meeting

Here are images from the American Medical Association (AMA) 2022 House of Delegates (HOD) meeting in Chicago, June 10-15. This was the first time the HOD met in two and a half years because of the COVID-19 pandemic.

June 15, 2022
Hospital finance, Despite improving margins, hospitals face a long road to recovery from the COVID pandemic

Collecting Earned Revenue: How AI Maximizes Radiology Payments

Sponsored by Infinx Healthcare

Today’s most pioneering radiology groups are using artificial intelligence to chase down payments, increase patient satisfaction, relieve front and back office workload, and recoup earned revenues.

May 18, 2022

FDA clears spinal-tap test that could challenge PET in Alzheimer’s diagnostics

The FDA has approved a lab test for evaluating cognitively impaired adults who may be in the early stages of Alzheimer’s disease.

May 5, 2022
Foot ultrasound bested foot MRI on pooled sensitivity while lagging on specificity

MRI beats ultrasound at grading common foot injury, but tables turn for up-or-down diagnostics

Injuries of the plantar plate—the cluster of ligaments underneath the four smaller “knuckles” of the toes—are better assessed with MRI than with ultrasound scans. 

May 4, 2022
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Major teaching hospital finds half its on-call abdominal ultrasounds call utilization into question

The investigators encourage radiologists to consider the numbers and take steps to “reinforce their gatekeeper function” to help cut ultrasound overutilization.

May 3, 2022
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VIDEO: The importance of the Physician Practice Information Survey and its impact on radiology reimbursements

Linda Wilgus, CPA, CMPE, executive director and chief financial officer of Northwest Radiology Network and a past president of the Radiology Business Management Association (RBMA), explains the importance of the Physician Practice Information Survey CMS in calculating radiology reimbursements.

April 25, 2022

New York cardiologist charged for alleged involvement in COVID-related fraud scheme

He was charged with three counts of healthcare fraud for an alleged scheme involving office visits that never occurred.

April 22, 2022