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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Philips-owned BioTelemetry to pay nearly $15M for allegedly misleading clinicians to secure higher reimbursements

The company and one of its subsidiaries would allegedly confuse clinicians and have them bill government programs for cardiac monitoring services that were more expensive than what they needed. This settlement resolves those allegations. 

December 20, 2023
Peter Moffatt, RBMA president-elect, discusses biggest issues facing radiology practices at RSNA 2023. #RBMA #RSNA #Radiology #CMScuts

Navigating the crucial challenges in radiology practice management

RBMA President-elect Pete Moffatt discusses how to contend with challenges such as staff shortages and reimbursement issues.

December 20, 2023
Video interview with Richard Heller, MD, RSNA Board member, associate chief medical officer for health policy and communications, and national director of pediatric radiology at Radiology Partners, explains the impact of the 2024 Medicare cuts on radiology and what comes next. #RSNA #RSNZA23 #RSNA2023 #CMS #Radiology

Putting US radiology reimbursement cuts in context and what comes next

Richard Heller, MD, a member of the RSNA Board and associate CMO for Rad Partners, explains the impact of the 2024 Medicare cuts and what is at stake.

December 11, 2023
Former managers of a Tampa Florida-based radiology company Advanced Diagnostic Group (ADG) and its employee stock ownership plan (ESOP) retirement benefit manager GreatBanc Trust Co. will pay $19 million to settle a class action lawsuit. The suit alleges they allowed the ESOP’s value to be diverted to managers, directors and their shell companies and away from employee participants. money gavel court lawsuit legal judge judgement

Kentucky health system, cardiologist to pay $3M for alleged scheme targeting Medicare and Medicaid

The alleged scheme involved a series of diagnostic procedures that, according to the U.S. government, were not medically necessary. 

December 7, 2023
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Cardiologists lead push for Aetna to reconsider ‘restrictive,’ ‘inconsistent’ reimbursement proposals

The policies cover a wide range of interventional therapies, including Shockwave Medical's IVL technology and intravascular ultrasound. 

December 6, 2023
Kit Crancer RBMA president on Medicare cuts RSNA 2023.

The impact of Medicare payment cuts on radiology and patient care access

RBMA President Kit Crancer said continued cuts will result in Medicare patients losing access to care when health systems and providers determine it is no longer economical.

December 5, 2023
Large crowd in the recruiters row on the RSNA expo floor. There was a record number of recruiters at RSNA this year as the radiologist shortage begins to hurt many healthcare systems. The shortage was also brought up in nearly all discussions Radiology Business has at RSNAS 2023. #RSNA #RSNA23 #RSNA2023

4 key trends in radiology at RSNA 2023

The rapidly growing shortage of radiologists and technologists was by far the biggest concern discussed across the Radiological Society of North America meeting.

December 1, 2023
Ultromics EchoGo AI platform. When the Centers for Medicare & Medicaid Services (CMS) finalized the 2024 Hospital Outpatient Prospective Payment System final rule, it included an updated reimbursement for the EchoGo Heart Failure platform from Ultromics. EchoGo Heart Failure is now associated with an ambulatory payment classification (APC) code of APC 5743 and a payment rate of $284.88.

CMS increases reimbursement for AI-powered heart failure platform

Ultromics thinks the significant payment increase will help ramp up utilization among U.S. healthcare providers.

November 8, 2023