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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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

December 7, 2022
Medicare money payment physician. The CardioVascular Coalition and Society for Cardiovascular Angiography and Interventions have both issued new statements highlighting their issues with the 2024 MPFS proposed rule. 

Hospitals and health systems face ‘dire’ financial situations

Financial operations have turned dire for hospitals and health systems, according to a recent report that reviewed significant revenue losses and rising costs.

 

November 15, 2022
ACC President Ed Fry, MD, an interventional and general cardiologist at Ascension St. Vincent Hospital in Indianapolis, Indiana, and chair of the Ascension National Cardiovascular Service Line, says Medicare cuts for 2023 are a tipping point that need to be a call to action across medicine. #AHA22 #ACC

VIDEO: ACC president says Medicare cuts should be a call to action across healthcare

American College of Cardiology President Edward Fry, MD, spoke about recent Medicare cuts at the American Heart Association Scientific Sessions conference in Chicago. 

November 9, 2022
The American College of Cardiology and Heart Rhythm Society issued a joint statement soon after CMS published its final rule for the 2023 Medicare Physician Fee Schedule. The groups warned that the final rule could threaten patient access to high-quality care. Medicare cuts may harm patient care.

Cardiologists, electrophysiologists ‘disappointed’ in final 2023 Medicare Physician Fee Schedule

The American College of Cardiology and Heart Rhythm Society issued a joint statement soon after CMS published its final rule for the 2023 Medicare Physician Fee Schedule. The groups warned that the final rule could threaten patient access to high-quality care. 

November 2, 2022
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.

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.

November 2, 2022
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. 

October 6, 2022
Dhanunjaya "DJ" Lakkireddy, MD, executive medical director for the Kansas City Heart Rhythm Institute at HCA Midwest Health, professor of medicine at the University of Missouri, Columbia, deputy editor for the the Journal of Atrial Fibrillation, and serves on the HRS Board of Trustees and section steering committee chair for the ACC, explains the potentially devastating impact of Medicare cuts on electrophysiology (EP) and patient care.

VIDEO: Medicare cuts could devastate the field of electrophysiology

"By imposing a 35%-42% cut, [CMS] has essentially created a scenario where it is going to destroy electrophysiology as a field," explained Dhanunjaya "DJ" Lakkireddy, MD.

October 4, 2022
Medicare money payment physician. The CardioVascular Coalition and Society for Cardiovascular Angiography and Interventions have both issued new statements highlighting their issues with the 2024 MPFS proposed rule. 

The fight continues: Cardiologists turn up heat on Congress to stop Medicare payment cuts

Dozens of medical societies have signed a new letter urging Congress to stop upcoming Medicare payment cuts. “The Medicare payment system remains on an unsustainable path threatening beneficiaries’ access to physicians," they wrote. 

September 23, 2022
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