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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Stephen Little, MD, discusses trends in echocardiography at ASE 2023. #ASE23 #ASE2023 What is new in cardiac ultrasound.

Back in the spotlight: Exploring echocardiography's revival

American Society of Echocardiography President Stephen Little, MD, says several trends and technologies are coming together at once, leading to renewed interest in echo.

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

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. 

Supplemental breast imaging modalities of automated breast ultrasound (ABUS) and molecular imaging.

VIDEO: Use of supplemental imaging in women with dense breasts

Society of Breast Imaging (SBI) President John Lewin, MD, discusses the types of supplemental breast imaging used to aid cancer detection in women with dense breast tissue.

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How radiology should prepare for AUC clinical decision support reporting requirements

An overview for the coming January 2023 mandate to use clinical decision support for all advanced imaging orders.

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.

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Around the web

Cardiovascular Business
Cardiology practices pay $17.7M to settle fraud allegations brought on by whistleblowers

A total of 16 cardiology practices from 12 states settled with the DOJ to resolve allegations they overbilled Medicare for imaging agents used to diagnose cardiovascular disease. 

Cardiovascular Business
Cardiology, radiology specialists debate CCTA’s rise as a go-to imaging modality for CAD

CCTA is being utilized more and more for the diagnosis and management of suspected coronary artery disease. An international group of specialists shared their perspective on this ongoing trend.

Cardiovascular Business
New AI program delivers rapid, accurate echo video assessments

The new technology shows early potential to make a significant impact on imaging workflows and patient care.