“The ruling is a step toward an IDR process that is accessible, fair and efficient,” Jacqueline Bello, chair of the ACR Board of Chancellors, said Monday. 

The payer has allegedly engaged in “slow pay and no pay tactics," resulting in an "enormous" volume of claims being denied or downgraded.

An organization could add an additional $87,532 on one MRI machine or over $260,000 via CT each year through strategic site selection, experts estimated.

The health insurer has faced criticism over its use of PA, including a class action lawsuit alleging it denied claims for imaging and other healthcare services in bulk

Supported by Chicago-based Madison Dearborn Capital Partners, the company has grown rapidly in recent years to now include 100-plus locations.

Since 2020, the “virtual practice” has grown to include more than 75 physicians operating across 47 states, with leaders seeking to hire more.

The company has raised $100 million in seed funding and earlier this year started Optain, which aims to identify diseases via retinal imaging. 

When stated in dollar terms, the median price for imaging services was $490 across commercial plans compared to $191 in MA, experts wrote in Health Affairs.